Vaginal stenosis and hydrometrocolpos: late complication of inadvertent perivaginal placement of an artificial urinary sphincter in prepubertal girls(1).
Urinary incontinence in pediatric and adolescent patients has been successfully managed with the artificial urinary sphincter for several decades. Placement of the sphincter can be difficult in the preadolescent girl due to poorly developed vaginal tissue that can result in difficulty establishing the surgical plane between the bladder and vagina. We report 2 patients in whom the sphincter was placed around the urethra and vagina, a complication that has been reported in only 1 patient previously. All 3 patients presented with hematometrocolpos and bloody vaginal discharge. All were successfully managed with replacement of the sphincter cuff around the urethra and delayed vaginoplasty.
Cain
M P
MP
Department of Urology, James Whitcomb Riley Hospital for Children, IndiSchool, Indianapolis, Indiana, USA
Rink
R C
RC
D000293:Adolescent; D002648:Child; D003251:Constriction, Pathologic / Q000601:surgery; D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008598:Menstruation; D014521:Urethra / Q000473:pathology*; D016741:Urinary Sphincter, Artificial / Q000009:adverse effects*; D014621:Vagina / Q000473:pathology* / Q000601:surgery*