Incidence: 0.6/10,000 female births. The urinary tract and vaginal canal are connected together but separated from the digestive tract. The cause is either malformative (rare) or related to a disorder of sexual development (see congenital adrenal hyperplasia and disorder of sexual development).
Two forms have been identified:
- low form (low confluence): where the urethra and vagina merge into a common canal near the common urogenital orifice; the length and anatomical position of both organs are almost normal
- high form (high confluence): where the urethra and vagina merge into a common canal away from the urogenital orifice; the urogenital sinus is long with often associated abnormalities such as an anteposed anus.
Symptomatology: abdominal distension (urinary retention), urinary tract infections, urinary incontinence
Treatment: more or less complex vaginoplasty; clitoridoplasty and labioplasty are rarely performed nowadays.
Anesthetic implications:
collegial surgical decision according to chromosomal sex and the extent of the malformation; in case of congenital adrenal hyperplasia, opotherapy; renal and lumbosacral spine echography. In the absence of lumbosacral canal or cord abnormalities, a caudal or lumbar epidural block may be combined with general anesthesia.
References :
- Singh S, Singh P, Singh RJ.
Persistent urogenital sinus.
J Anat Soc India 2012 ; 59 : 242-4.
Updated: August 2022