Transient urocolpos due to vesicovaginal reflux in a 37-year-old woman: a case report

Abstract

Urocolpos is a urine collection in the vagina, possibly due to vesicovaginal reflux (VVR) or a fistula. Urocolpos is a rare phenomenon in adults, and it is commonly underrecognized by radiologists. The occurrence of urocolpos due to VVR after a Caesarean section in adult females is a rare phenomenon; failure to recognize it may lead to misdiagnosis as vesicovaginal fistula and often leads to unnecessary medical interventions. We report a 37-year-old female who complained of abdominal pain and intermittent daytime urinary incontinence for six months, starting after a Caesarean section for her third baby. An abdominal computed tomography scan revealed a large fluid-filled vagina on a full bladder without anatomical abnormality. A post-voiding scan showed a complete resolution. In conclusion, urocolpos is an underrecognized entity that rarely coexists with VVR. Post-voiding resolution and vaginal contrast reflux are important findings that can aid radiologists in identifying such cases.

Vesicovaginal reflux presenting as transient urocolpos—A diagnostic dilemma

“…It is also an underestimated cause of urinary incontinence in adult women [4] . The occurrence of urocolpos due to VVR after a Caesarean section in adult females is a rare phenomenon; failure to recognize it may lead to misdiagnosis as vesicovaginal fistula and often leads to unnecessary medical interventions [2] .…”

“…The peripubertal adolescent is educated to keep her legs well apart while voiding and to devote adequate time to bladder emptying [1 , 7] . Postvoiding vaginal emptying by finger introduction/tampon in a cross-legged position and strengthening the pelvic floor by exercises are taught to the older patient [2] .…”

“…Vesicovaginal reflux (VVR) is defined as the retrograde reflux of urine into the vaginal vault during voiding. It is usually seen in adolescent girls with urinary incontinence [1] ; however, middle-aged women are also affected [2] . The etiology is unclear, postulations are close apposition of labia, relatively horizontal orientation of the vagina or closing the legs when voiding [4] .…”