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Vesicovaginal Reflux Mimicking Obstructive Hydrocolpos

Department of Radiology, Nationwide Children’s Hospital, Columbus, Ohio USA.

Address correspondence to Brian D. Coley, MD, Department of Radiology, Nationwide Children’s Hospital, 700 Children’s Dr, Columbus, OH 43205 USA. E-mail: brian.coley{at}nationwidechildrens.org

Objective. The purpose of this study was to describe a series of cases of hydrocolpos that proved to be due to vesicovaginal reflux. Methods. Cases with a diagnosis of hydrocolpos or a fluid-filled vagina identified from our ultrasound database were retrospectively reviewed. The results from sonographic and fluoroscopic studies were reviewed, along with demographic and clinical data. Results. Four patients had sonographic findings mimicking obstructive hydrocolpos that resolved after voiding. Fluoroscopic studies showed abnormal urethral morphologic characteristics in all 4, diminished bladder capacity in 3, and vesicovaginal reflux in 3. No anatomic abnormalities were identified. Conclusions. Vesicovaginal reflux can produce vaginal distension that is sonographically identical to obstructive hydrocolpos. This may be due to dysfunctional voiding issues. Postvoid sonography allows proper diagnosis.

Key Words: hydrocolpos • pediatrics • reflux • voiding dysfunction

Abbreviations: STU, spinning top urethra • UTI, urinary tract infection • VCUG, voiding cystourethrography • VVR, vesicovaginal reflux