title: Adolescent urethral coitus: 2 cases and review of the literature.
abstract: BACKGROUND
  Urethral coitus is a very rare finding in adolescent women. There are 26 reported cases in the literature, but only two were in adolescents. Urethral coitus has been most commonly described in women with müllerian anomalies and less commonly in other unusual clinical circumstances.
  
  
  METHODS
  We report 2 cases of adolescent women with known müllerian anomalies who were unknowingly engaging in urethral coitus; 1 adolescent with known vaginal agenesis and VACTERL association and one 16-year-old with an oblique vaginal septum and non-communicating functioning uterine horn. Both young women had significant urethral dilation at the time of examination under anesthesia.
  
  
  CONCLUSIONS
  Urethral intercourse is rare but may have significant consequences. Ongoing follow-up, careful history, and physical examination in adolescent women with müllerian anomalies are important in order to avoid possible complications, particularly when they are contemplating sexual activity. A history of urinary incontinence, dyspareunia, and urinary tract infections in young women with müllerian anomalies should raise suspicion of urethral coitus. If possible, the müllerian anomaly should be corrected to allow vaginal intercourse and discontinuation of urethral coitus.
authors: Department of Obstetrics and Gynecology, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors: Julie
authors: J
authors: Ryckman
authors: Department of Obstetrics and Gynecology, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Division of Gynecology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
authors: Amanda
authors: A
authors: Black
authors: Department of Obstetrics and Gynecology, The Ottawa Hospital, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Division of Gynecology, Children's Hospital of Eastern Ontario, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: nfleming@cheo.on.ca.
authors: Nathalie
authors: N
authors: Fleming
mesh_terms: D000293:Adolescent; D001003:Anal Canal / Q000002:abnormalities; D003075:Coitus; D004947:Esophagus / Q000002:abnormalities; D005260:Female; D006330:Heart Defects, Congenital / Q000150:complications; D006801:Humans; D007668:Kidney / Q000002:abnormalities; D017880:Limb Deformities, Congenital / Q000150:complications; D013131:Spine / Q000002:abnormalities; D014132:Trachea / Q000002:abnormalities; D014521:Urethra / Q000473:pathology; D014599:Uterus / Q000002:abnormalities; D014621:Vagina / Q000002:abnormalities* / Q000601:surgery
keywords: Adolescent; Müllerian anomalies; Urethral coitus; Urinary incontinence