Kanneganti P, Verma A, Upadhyaya VD, Gautam AD. Clinical conundrum in the management of complex urogenital anomaly in a child: A case report. World J Clin Pediatr 2026; 15(4): 120972 [DOI: 10.5409/wjcp.120972]
Corresponding Author of This Article
Pujana Kanneganti, Assistant Professor, Department of Paediatric Surgery Superspecialties, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raibareli Road, Lucknow 226014, Uttar Pradesh, India. pujanakanneganti@gmail.com
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Pediatrics
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case-report
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Kanneganti P, Verma A, Upadhyaya VD, Gautam AD. Clinical conundrum in the management of complex urogenital anomaly in a child: A case report. World J Clin Pediatr 2026; 15(4): 120972 [DOI: 10.5409/wjcp.120972]
World J Clin Pediatr. Dec 9, 2026; 15(4): 120972 Published online Dec 9, 2026. doi: 10.5409/wjcp.120972
Clinical conundrum in the management of complex urogenital anomaly in a child: A case report
Pujana Kanneganti, Anju Verma, Vijai Datta Upadhyaya, Avinash D Gautam
Pujana Kanneganti, Anju Verma, Department of Paediatric Surgery Superspecialties, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Vijai Datta Upadhyaya, Department of Pediatric Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Avinash D Gautam, Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow 226014, Uttar Pradesh, India
Co-first authors: Pujana Kanneganti and Anju Verma.
Author contributions: Kanneganti P managed the patient, collected clinical data and drafted the manuscript; Verma A performed literature review and revised the manuscript; Upadhyay VD provided expert guidance in the clinical management and supervised the treatment plan; Gautam AD provided expert guidance in radiological reviews.
Informed consent statement: Written informed consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Pujana Kanneganti, Assistant Professor, Department of Paediatric Surgery Superspecialties, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raibareli Road, Lucknow 226014, Uttar Pradesh, India. pujanakanneganti@gmail.com
Received: March 18, 2026 Revised: April 20, 2026 Accepted: May 6, 2026 Published online: December 9, 2026 Processing time: 189 Days and 18.3 Hours
Abstract
BACKGROUND
Urogenital anomalies in female paediatric population are well-recognized but can be challenging to diagnose and manage depending on the complexity. Congenital vesicovaginal fistula is an uncommon entity and can present as isolated anomaly or associated with multiple malformations of wide spectrum. We report a rare complex urogenital anomaly case of 2-year-old female child presenting with pyometrocolpos with distal vaginal atresia, congenital vesicovaginal fistula and solitary functioning kidney.
CASE SUMMARY
A 2-year-old female child presented with a febrile urinary tract infection and abdominal distension in acute renal failure. Clinical evaluation revealed lower midline firm, tense, immobile abdominal lump of size 11 cm × 10 cm. External genitalia examination showed 2 openings in perineum with absent vaginal opening. Initial radiological evaluation showed pyometrocolpos with distal vaginal atresia and left solitary functioning kidney. This patient underwent staged management including treatment for acute renal failure and pyometrocolpos decompression, followed by final surgical treatment with the repair of vesicovaginal fistula and pull through vaginoplasty. Immediate postoperative recovery was uneventful but a follow-up visit at 3 months showed vaginal stenosis which was managed with serial dilations. At 18 months follow up, neovaginal opening remains patent with preserved renal function and no other complications.
CONCLUSION
This case report underscores the importance of diligent clinical vigilance and timely intervention in the patients with complex urogenital anomalies.
Core Tip: Diagnosing congenital urogenital anomalies requires a thorough understanding of embryology to recognize the spectrum of possible defects. This case illustrates the diagnostic complexity and need for coordinated urological and gynecological management in patients with rare congenital urogenital abnormalities. Management should be individualized, requiring a multidisciplinary approach, surgical correction when required, and long-term follow-up to prevent complications like stenosis, recurrent infections, infertility. Detailed counseling with parents and guardians is essential for treatment options and their implications.
