title: Congenital vesicovaginal fistula with menouria: an anomaly of the urogenital sinus.
abstract: OBJECTIVE
  To describe the diagnostic and therapeutic process for a congenital exceptional anomaly. To analyze the pathogenesis of the embryologic anomalies associated with menouria and congenital vesicovaginal fistula (VVF).
  
  
  METHODS
  The case of a 28-year-old female with menouria and impossibility of consummating coitus is described. The diagnostic method is analyzed. The type of treatment is described and finally we conclude with a hypothesis about embryology of congenital anomalies with VVF and menouria.
  
  
  RESULTS
  For management of anomalies as congenital VVF, imaging tests including cystography and urography could not correctly visualize the fistulous tract. It was identified by cystoscopy, performed during the time of menouria. Surgical treatment consisted in repairing the VVF and vaginoplasty according to the McIndoe technique.
  
  
  CONCLUSIONS
  All women with menouria need complete investigation with exhaustive exploration, analytic evaluation, ultrasound, imaging tests (principally magnetic resonance) and, very importantly, cystoscopy on the days of menouria. Surgical treatment must be careful and individualized. This case allows us to hypothesise that the blind vagina encountered reflects an anomaly of correct urogenital sinus development.
authors.affiliation: Service of Obstetrics and Gynecology, University General Hospital of Alicante, Spain. martinez_jca@gva.es
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Martínez Escoriza
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Lobato
authors.forename: Elena
authors.initials: E
authors.lastname: Lorda
authors.forename: Monica
authors.initials: M
authors.lastname: De Vera
authors.forename: Antonio
authors.initials: A
authors.lastname: Moya
authors.forename: Romina
authors.initials: R
authors.lastname: Ramirez
authors.forename: Oscar Piñero
authors.initials: OP
authors.lastname: Sánchez
mesh_terms: D000328:Adult; D003558:Cystoscopy; D005260:Female; D006417:Hematuria / Q000209:etiology*; D006801:Humans; D008598:Menstruation; D019651:Plastic Surgery Procedures; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D016896:Treatment Outcome; D014621:Vagina / Q000002:abnormalities / Q000601:surgery; D014719:Vesicovaginal Fistula / Q000151:congenital* / Q000175:diagnosis / Q000503:physiopathology* / Q000601:surgery