An unusual cause of urinary incontinence: Urethral coitus in a case of Mayer-Rokitansky-Kuster-Hauser syndrome.
Mayer-Rokitansky-Kuster-Hauser (MRKH) syndrome is a rare anomaly in women and is characterized by congenital aplasia of the uterus and vagina, with normal development of secondary sexual characteristics and a normal karyotype. We report a case of a 38-year-old women with MRKH syndrome that had experienced urethral sex for many years. She presented with urinary incontinence and dyspareunia. The patient's secondary sexual characteristics were normal, and examination revealed a widely open incompetent megalourethra and an absent vagina. Laboratory studies confirmed a 46, XX karyotype. Imaging included ultrasonography and magnetic resonance imaging, which indicated bilateral normal ovaries and a rudimental bicornuate uterus. After confirming the diagnosis of MRKH, the patient underwent urethroplasty by urethral plication, antiincontinence surgery by autologous fascial sling of the bladder neck, and the creation of a neo-vagina using a urethral flap. After 3 months, voiding cystourethrography and uroflowmetry confirmed normal voiding. There were no postoperative symptoms of urinary incontinence, and the patient was completely satisfied.
Urology-Nephrology Research Center, Labbafinejad Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Farzaneh
F
Sharifiaghdas
Department of Urology, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Azar
A
Daneshpajooh
Department of Obstetrics and Gynecology, Afzalipour Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Samira
S
Sohbati
Department of Urology, Shahid Bahonar Hospital, Kerman University of Medical Sciences, Kerman, Iran.
Mahboubeh
M
Mirzaei
D058489:46, XX Disorders of Sex Development / Q000150:complications* / Q000601:surgery; D000328:Adult; D003075:Coitus; D000013:Congenital Abnormalities / Q000601:surgery; D005260:Female; D006801:Humans; D009095:Mullerian Ducts / Q000002:abnormalities* / Q000601:surgery; D053825:Suburethral Slings; D019738:Surgically-Created Structures; D013577:Syndrome; D014521:Urethra / Q000002:abnormalities / Q000601:surgery; D014549:Urinary Incontinence / Q000209:etiology* / Q000601:surgery
Plastic surgery; Urethra; Urinary incontinence