ESPN 50th Annual Meeting

ESPN 2017


 
Congenital vesicovaginal fistula in 8-months old baby of a diabetic mother- clinical case report
MARIA GAYDAROVA 1 GALIA ZLATANOVA 1 STEFKA JANKOVA 1 BORIS STOILOV 1 DIMITAR ROUSSINOV 1 SVETLANA MARINOVA 1 DANIELA AVDJIEVA 1 HADIL KADAM 1

1- UNIVERSITY PEDIATRIC HOSPITAL
 
Introduction:

 Vesicovaginal fistula in childhood usually occurs following penetrating trauma, foreign bodies and genitourinary surgery.  However, a congenital vesicovaginal fistula is a very rare entity. 

Material and methods:

 Herein we report a 8-months old girl, born from second pregnancy of a diabetic mother after Cesarean section. After the delivery multiple skeletal, facial and renal anomalies were found plus hydrocephalia. Because recurrent febrile urinary tract infections (UTI) from her first month of age she was referred for further investigations. There was no history of surgical procedures, foreign body or trauma in the genitourinary tract which might have created  a vesicovaginal fistula

Results:

 

 From the physical status she was with epicant, short palpebral fissures, low set protrudent dysplastic ears, horizontally placed proximal flank of the lower limb, short lower legs ( rhiso-and mesomelia) and club feet. She was with signs of UTI. From the US- hydronephrosis with hydrocalycosis of the left kidney. Excretory urography showed a hydronephrotic left kidney and contrast material drained into the vagina. Cystography revealed a vesicovaginal fistula without vesico-ureteral reflux. Gynecologyst found out inperforated hymen, with normal uterus and filled with fluid vagina. MLPA scrinning for microdeletion syndromes, subtelomer deletions and duplications was negative. Now she is on antibiotic prophylaxis and waiting for surgical procedure.

 

Conclusions:

 Vesicovaginal fistula is a rare congenital anomaly in childhood. In our case we report a baby of a diabetic mother, which does not have any laboratory findings of diabetes, admitted after reccurent febrile urinary tract infections. Early diagnostis and immediate surgical treatment could prevent the further renal damage.