Case Report: Vaginostomy until further reconstruction for the management of hydrocolpos causing hydronephrosis

Hydrometrocolpos in an infant with urological complications: a rare case and review of literature

“…Hydrometrocolpos is a rare congenital condition with an incidence of about 0.006% [ 2–4 ]. It can be caused by imperforate hymen, transverse vaginal septum, cloacal malformation, distal vaginal agenesis and persistent urogenital sinus, with the former being the most prevalent congenital anomaly [ 1 , 3 , 5 , 6 ]. It is classified into five types based on the level of obstruction as well as the severity of the malformation: type I (imperforate hymen), type II (vaginal septum), type III (distal vagina agenesis), type IV (vaginal atresia with persistent urogenital sinus) and the last one is type V, the most severe form that is characterised by atresia of the vagina associated with cloacal malformation [ 7 ].…”

“…Hydrometrocolpos can be isolated or associated with syndromes such as the Mckusick Kaufman syndrome, Mayer–Rokitansky–Küste–Hauser syndrome and Herlyn–Werner–Wundelich syndrome [ 2–4 , 7 ]. Some cases of hydrometrocolpous may have associated abnormal connection with the urinary tract or gastrointestinal tract (fistulae) [ 5 , 8 ]. Our case did not have any syndromic phenotypic features nor fistula between the urogenital and gastrointestinal tracts.…”

“…Hydrometrocolpos is characterised by distension of the vagina and uterus as a result of accumulation of fluid due to distal obstruction presenting as a cystic abdominal mass [ 2 , 5 , 7 ]. There are a number of conditions that presents with cystic mass in children including ovarian cyst, cystic sacrococcygeal teratoma, enteric duplication, urachal cyst and cystic renal masses [ 1 , 2 , 8 ].…”

“…It can result into various complications due to pressure effect on the surrounding structures. These include urinary tract obstruction, recurrent urinary tract infection, urine retention (renal insufficiency), rupture of the urinary bladder, sepsis, intestinal obstruction and constipation [ 2 , 4 , 5 , 7 ]. Our case presented both constipation and retention of urine due to a severely dilated uterus and vaginal cavity.…”

“…Our case presented both constipation and retention of urine due to a severely dilated uterus and vaginal cavity. Some of these complications can be life threatening [ 1 , 5 ], as this case and hence rapid decompression of the distended vagina/uterus is essential as it is life serving. In this case, we believe the cause of fever was urinary tract infection that was managed by ceftriaxone and bladder drainage using urethral as a catheter.…”