Menouria due to congenital vesicovaginal fistula associated with complex genitourinary malformation

BACKGROUND: Congenital vesicovaginal fistula (VVF) is a very uncommon condition rarely suspected at initial presentation. It is usually seen in association with complex malformations of the genitourinary tract. CASE: A bifid insertion of the solitary ureter causing an uretero–VVF was associated with an obstructing transverse vaginal septum manifesting as menouria. Also seen were solitary crossed renal ectopia, bicornuate uterus and skeletal anomalies. CONCLUSION: In women with menouria without vaginal menstruation, pre-operative evaluation to detect an obstructive vaginal anomaly and unusual uretero–vesicovaginal fistulous communications is necessary before surgical intervention.