title: [Vesicovaginal Reflux and Urocolpos].
abstract: OBJECTIVE
  Vesico-vaginal reflux (VVR) is defined as the reflux of urine into the vaginal vault during voiding, occasionally seen in pre- adolescent girls. The typical history consists in post voiding leaks in the daytime, that correspond to the progressive urine discharge from the vagina, after it has been filled up during micturition. We intend to show two cases presenting with significant urocolpos.
  
  
  METHODS
  Description of two clinical cases observed in the pediatric urology office.
  
  
  RESULTS
  Clinical case 1.- A 10-year-old girl presented with the complaint of diurnal incontinence (in the immediate post-voiding minutes). The early voiding phase in the cystourethrogram (VCUG) demonstrated progressive gross distension of the vagina (urocolpos) due to retrograde filling as the bladder emptied. The girl was managed with behavioural modifications, and was dry afterwards. Clinical case 2.- A 9-year-old girl presented with history of incomplete voiding. In infancy, she had right-sided vesicoureteral reflux (VUR) and was endoscopically treated at the age of 2. VCUG showed VVR, and no VUR. She was then successfully treated with behavioural modifications. Clinical case 3.- A 10-year-old girl complained of diurnal urinary incontinence, described as post voiding leaks. Again, a VCUG showed VVR and a small urocolpos. After re-education of voiding habits, leaks disappeared, but recurred 6 months afterwards, when she acknowledged no adherence to the therapy.
  
  
  CONCLUSIONS
  Between 12 to 15% of girls referred to Urological clinics because of urine incontinence present VVR. In the absence of a clear anatomical obstruction, reflux happens as the urine flow encounters a natural obstacle in the labia majora usually in girls that close their legs as they void. Instructions on proper voiding form a key element in the management of VVR, and if not enough, the behavioural modification consists on a reverse position during voiding.
authors.affiliation: Sección de Urología Pediátrica. Servicio de Cirugía Pediátrica.
authors.forename: María
authors.initials: M
authors.lastname: Fernández-Ibieta
authors.affiliation: Sección de Urología Pediátrica. Servicio de Cirugía Pediátrica.
authors.forename: Irene
authors.initials: I
authors.lastname: Martínez-Castaño
authors.affiliation: Sección de Urología Pediátrica. Servicio de Cirugía Pediátrica.
authors.forename: María José
authors.initials: MJ
authors.lastname: Guirao-Piñera
authors.affiliation: Unidad de Nefrología. Servicio de Pediatría.
authors.forename: Carmen
authors.initials: C
authors.lastname: Vicente-Calderón
authors.affiliation: Unidad de Nefrología. Servicio de Pediatría.
authors.forename: Juan
authors.initials: J
authors.lastname: Piñero-Fernández
authors.affiliation: Sección de Urología Pediátrica. Servicio de Cirugía Pediátrica.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Zambudio-Carmona
authors.affiliation: Enfermera Urodinamista. Servicio de Cirugía Pediátrica. Hospital Clínico Universitario de la Arrixaca. Murcia. EspaÑa.
authors.forename: Ascención
authors.initials: A
authors.lastname: García-López
authors.affiliation: Sección de Urología Pediátrica. Servicio de Cirugía Pediátrica.
authors.forename: José Ignacio
authors.initials: JI
authors.lastname: Ruiz-Jiménez
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D014556:Urine; D014621:Vagina; D014718:Vesico-Ureteral Reflux / Q000150:complications*