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.