Children' s Hospital, Harvard Medical School
Boston, Massachusetts
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Robert
L. Lebowitz, M.D.
Children' s Hospital, Harvard Medical School Boston, Massachusetts |
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A 3 year-old girl was almost constantly wet in spite of normal toilet training. She had a febrile urinary tract infection. At the time of catheterization for VCUG, it was not realized there was only one interlabial orifice. This was catheterized (it was the UG sinus) and the catheter went into the vagina. The vagina was filled and a cervix was seen at its apex. There was then retrograde filling of the urethra and bladder. Even though there was a relatively long urethra, retrograde filling of the urethra and the bladder suggest poor bladder neck-sphincter tone. She also had bilateral ureteral reflux. She underwent bladder neck reconstruction, separation of the vagina from the urethra-UG sinus, and the vagina was pulled down to the perineum.
Figure 1 |