Congenital vesicovaginal fistula with transverse vaginal septum and ectopic ureter opening in proximal vagina: case report and brief review

Abstract

Congenital vesicovaginal fistula is an extreme rarity. We report on a case of a 22-year-old lady who presented with menouria and infertility. On evaluation, she was found to have congenital vesicovaginal fistula, a nonfunctioning right kidney with ectopic ureter and transverse vaginal septum. Abdominal repair of the fistula, right nephroureterectomy, and excision of the vaginal septum was performed.

Robotic repair of congenital vesicovaginal fistula masquerading as a ureterocele in a 10-year-old girl

“… 4 Others have reported CVVF associated with dysplastic kidney with ectopic ureteric insertion at the proximal vagina. 3 …”

“… 1 , 4 When vaginal obstruction is present, recurrent urinary tract infection may occur in childhood, or if there is delay in making the diagnosis, affected adults present with menouria and difficulty in sexual intercourse. 1 , 2 , 3 In this report we presented a case which was initially managed as ureterocele while the final diagnosis was CVVF associated with distal vaginal agenesis and a dysplastic kidney.…”

“…While CVVF can occur in isolation, more commonly it coexists with urological anomalies and vaginal obstruction due to distal vaginal agenesis or transverse vaginal septum. 1 , 2 , 3 Children present with continuous urinary incontinence if vagina is normal. 1 , 4 When vaginal obstruction is present, recurrent urinary tract infection may occur in childhood, or if there is delay in making the diagnosis, affected adults present with menouria and difficulty in sexual intercourse.…”

Primary Menouria due to Congenital Urethrovaginal Fistula with Vaginal Agenesis

“…Endodermal outgrowths from the urogenital sinus known as the sinovaginal bulbs give rise to the distal vagina. 3 The sinovaginal bulb extent and fuse to the uterovaginal primordium to form the vaginal plate. Subsequently, patent vagina is formed by the canalization of the vaginal plate.…”

“…The management of vaginal atresia along with CUVF is described as closure of the CUVF and reconstruction of a neovagina. 3,4 For creation of neovagina various techniques has been described but the best option for functional outcome and sexual satisfaction with the least morbidity is still unknown. We used pull-through vaginoplasty.…”