Configuration of the prepubertal hymen

Anatomically descriptive terms are required when one is asked to comment on the hymen of the sexually abused prepubertal child. Action descriptive terms such as virginal or ruptured relay no objective information. Biologic hymenal configurations can be loosely categorized by the amount and distribution of hymenal tissue surrounding the vaginal introitus: The terms fimbriated, circumferential, and posterior rim are proposed. Descriptions of 124 prepubertal hymens are presented, with discussion focusing on biologic configurations and the impact of trauma and hormones.