title: Novel approach to vaginal calculus in a girl with urogenital sinus anomaly.
abstract: Isolated urogenital sinus can cause distended bladder and/or vagina and may present with an abdominal mass and sepsis during infancy. Older children may present with recurrent urinary tract infections and hematocolpos. We describe a 3-year-old girl with recurrent urinary tract infections thought to be secondary to vesicoureteric reflux. On further investigation, an isolated urogenital sinus anomaly with a calculus inside one of the hemivaginae was noted. She was managed expectantly with a plan to intervene at puberty. At puberty, during removal of the stone, the hemivaginal introitus was found to be stenotic. Gradually increasing sizes of Amplatz type graduated renal dilators were introduced from the introitus of the urogenital sinus into the hemivaginal stone until a size 22F Amplatz sheath could be passed easily. Size 10F cystoscope was passed through this channel, and the stone was fragmented using electrohydraulic lithotripsy. At a later date, she underwent staged anterior sagittal transvulval mobilization of the urogenital sinus.
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester M13 9WL, United Kingdom.
authors.forename: Ravibindu Sujeewa
authors.initials: RS
authors.lastname: Ranawaka
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester M13 9WL, United Kingdom.
authors.forename: Anju
authors.initials: A
authors.lastname: Goyal
authors.affiliation: Department of Paediatric Radiology, Royal Manchester Children's Hospital, Manchester M13 9WL, United Kingdom.
authors.forename: Abdusamea
authors.initials: A
authors.lastname: Shabani
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester M13 9WL, United Kingdom.
authors.forename: Supul
authors.initials: S
authors.lastname: Hennayake
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester M13 9WL, United Kingdom.
authors.forename: Alan P
authors.initials: AP
authors.lastname: Dickson
authors.affiliation: Department of Paediatric Urology, Royal Manchester Children's Hospital, Manchester M13 9WL, United Kingdom. Electronic address: raimondo.cervellione@cmft.nhs.uk.
authors.forename: Raimondo M
authors.initials: RM
authors.lastname: Cervellione
mesh_terms: D002137:Calculi / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008096:Lithotripsy; D014552:Urinary Tract Infections; D014564:Urogenital Abnormalities / Q000150:complications / Q000175:diagnosis; D014621:Vagina / Q000503:physiopathology*
keywords: Hemivagina; Intracorporeal lithotripsy; Urogenital sinus; Vaginal calculus