Primary menouria due to a congenital vesico-vaginal fistula with distal vaginal agenesis: a rarity.
We present the case of a female aged 16 years, suffering from cyclical menouria for the last 3 years. Clinical examination revealed the absence of a vagina. Cystoscopy performed while the patient was having menouria revealed an orifice (10 × 8 mm) in the supratrigonal region; blood clots were entering the urinary bladder through this orifice. Magnetic resonance imaging of the pelvis depicted a fluid-filled longitudinal tract distal to the uterus (which was the upper vagina), between the cervix and the bladder. Diagnostic laparoscopy confirmed the presence of a uterus, both ovaries, and the tubal structures. Exploratory laparotomy, correction of the fistulous tract, and sigmoid vaginoplasty were performed. The distal part of the fistulous tract (urinary bladder end) was anastomosed to the proximal end of the sigmoid neo-vagina. The patient is doing well as per her last follow-up at 6 months. She has started menstruating per neo-vagina.
Department of Urology, Chhatrapati Shahuji Maharaj Medical University (formerly King George's Medical University), Lucknow, UP 226003, India. vishwajeeturo@sify.com
Vishwajeet
V
Singh
Rahul Janak
RJ
Sinha
Seema
S
Mehrotra
D000015:Abnormalities, Multiple; D000293:Adolescent; D005260:Female; D006801:Humans; D014555:Urination Disorders / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000150:complications* / Q000151:congenital* / Q000601:surgery
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