Clinical conundrum in the management of complex urogenital anomaly in a child: A case report

Abstract

BACKGROUND: Urogenital anomalies in female paediatric population are well-recognized but can be challenging to diagnose and manage depending on the complexity. Congenital vesicovaginal fistula is an uncommon entity and can present as isolated anomaly or associated with multiple malformations of wide spectrum. We report a rare complex urogenital anomaly case of 2-year-old female child presenting with pyometrocolpos with distal vaginal atresia, congenital vesicovaginal fistula and solitary functioning kidney.

CASE SUMMARY: A 2-year-old female child presented with a febrile urinary tract infection and abdominal distension in acute renal failure. Clinical evaluation revealed lower midline firm, tense, immobile abdominal lump of size 11 cm × 10 cm. External genitalia examination showed 2 openings in perineum with absent vaginal opening. Initial radiological evaluation showed pyometrocolpos with distal vaginal atresia and left solitary functioning kidney. This patient underwent staged management including treatment for acute renal failure and pyometrocolpos decompression, followed by final surgical treatment with the repair of vesicovaginal fistula and pull through vaginoplasty. Immediate postoperative recovery was uneventful but a follow-up visit at 3 months showed vaginal stenosis which was managed with serial dilations. At 18 months follow up, neovaginal opening remains patent with preserved renal function and no other complications.

CONCLUSION: This case report underscores the importance of diligent clinical vigilance and timely intervention in the patients with complex urogenital anomalies.

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BibTeX RIS

BibTeX

@article{kanneganti2026clinical,
  title = {{Clinical conundrum in the management of complex urogenital anomaly in a child: A case report}},
  author = {Pujana Kanneganti and Anju Verma and Vijai Datta Upadhyaya and Avinash D Gautam},
  journal = {World Journal of Clinical Pediatrics},
  year = {2026},
  month = nov,
  doi = {10.5409/wjcp.120972},
  url = {https://doi.org/10.5409/wjcp.120972},
  note = {CC BY-NC 4.0},
}

RIS

TY  - JOUR
TI  - Clinical conundrum in the management of complex urogenital anomaly in a child: A case report
AU  - Pujana Kanneganti
AU  - Anju Verma
AU  - Vijai Datta Upadhyaya
AU  - Avinash D Gautam
PY  - 2026
DA  - 2026/11/03
JO  - World Journal of Clinical Pediatrics
DO  - 10.5409/wjcp.120972
UR  - https://doi.org/10.5409/wjcp.120972
AB  - BACKGROUND: Urogenital anomalies in female paediatric population are well-recognized but can be challenging to diagnose and manage depending on the complexity. Congenital vesicovaginal fistula is an uncommon entity and can present as isolated anomaly or associated with multiple malformations of wide spectrum. We report a rare complex urogenital anomaly case of 2-year-old female child presenting with pyometrocolpos with distal vaginal atresia, congenital vesicovaginal fistula and solitary functioning kidney.  CASE SUMMARY: A 2-year-old female child presented with a febrile urinary tract infection and abdominal distension in acute renal failure. Clinical evaluation revealed lower midline firm, tense, immobile abdominal lump of size 11 cm × 10 cm. External genitalia examination showed 2 openings in perineum with absent vaginal opening. Initial radiological evaluation showed pyometrocolpos with distal vaginal atresia and left solitary functioning kidney. This patient underwent staged management including treatment for acute renal failure and pyometrocolpos decompression, followed by final surgical treatment with the repair of vesicovaginal fistula and pull through vaginoplasty. Immediate postoperative recovery was uneventful but a follow-up visit at 3 months showed vaginal stenosis which was managed with serial dilations. At 18 months follow up, neovaginal opening remains patent with preserved renal function and no other complications.  CONCLUSION: This case report underscores the importance of diligent clinical vigilance and timely intervention in the patients with complex urogenital anomalies.
SN  - 2219-2808
ER  -

Abstract

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