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Virtual Pediatric Hospital: Paediapaedia: Hydrometrocolpos Paediapaedia: Genitourinary Diseases

Hydrometrocolpos

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed


Clinical Presentation:
Palpable midline mass that on rectal examination is anterior to the rectum.

Etiology/Pathophysiology:
Usually due to vaginal atresia with the patient developing a prenatal collection of fluid filling a dilated uterus (metro) and vagina (colpos). Often has a urogenital sinus opening onto the perineum and the urethra is at apex of the sinus. The urethra can be obstructed by this fluid filled mass and this can result in fetal anuria, oligohydramnios, and pulmonary hypoplasia. Occasionally reflux of secretions through the fallopian tubes into the peritoneal cavity can be associated with an adhesive peritonitis.

Pathology:
Not applicable

Imaging Findings:
Abdominal films shows a midline mass rising out of the pelvis.

Ultrasound shows a tubular midline mass that has a complicated cystic appearance that lies between the bladder anteriorly and the rectum posteriorly. The kidneys and ureters need to be evaluated for obstruction by the mass.

DDX:

References:
See References Chapter.

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