A Case of Persistent Urogenital Sinus Pitfalls and challenges in diagnosis
Journal Title: Sultan Qaboos University Medical Journal - Year 2017, Vol 17, Issue 4
Abstract
Persistent urogenital sinus (PUGS) is a rare anomaly whereby the urinary and genital tracts fail to separate during embryonic development. We report a three-year-old female child who was referred to the Sabah Women & Children Hospital, Sabah, Malaysia, in 2016 with a pelvic mass. She had been born prematurely at 36 gestational weeks via spontaneous vaginal delivery in 2013 and initially misdiagnosed with neurogenic bladder dysfunction. Te external genitalia appeared normal and an initial sonogram and repeat micturating cystourethrograms did not indicate any urogenital anomalies. She therefore underwent clean intermittent catheterisation. Tree years later, the diagnosis was corrected following the investigation of a persistent cystic mass posterior to the bladder. At this time, a clinical examination of the perineum showed a single opening into the introitus. Magnetic resonance imaging of the pelvis revealed gross hydrocolpos and a genitogram confrmed a diagnosis of PUGS, for which the patient underwent surgical separation of the urinary and genital tracts.
Authors and Affiliations
Hooi H. Tan| Department of Radiology, Hospital University Kebangsaan Malaysia, Kuala Lumpur, Malaysia, Shung K. Tan| Division of Paediatric Surgery, Department of Surgery, University of Malaya, Kuala Lumpur, Malaysia, Department of Paediatric Surgery, Sabah Women & Children Hospital, Sabah, Malaysia, Rajah Shunmugan| Department of Paediatric Surgery, Sabah Women & Children Hospital, Sabah, Malaysia, Rozman Zakaria| Department of Radiology, Hospital University Kebangsaan Malaysia, Kuala Lumpur, Malaysia, Zakaria Zahari| Department of Paediatric Surgery, Institut Pediatrik Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
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