16-Month-Old Female Patient Prenatally Suspected of Having Ureterocele

• 16-mo female patient presents for evaluation.
• She had the prenatal diagnosis of ureterocele.
• Images obtained postnatally included ultrasound that showed bladder with a cystic mass behind it with layering of two different types of fluid. This was a hydrocolpos.
• MRI postnatally showed the bladder compressed by a giant hydrocolpos. This is more easily identified on sagittal MRI images.
• Patient underwent excision of urachal cyst and attempted vaginal septum removal.
• Follow-up images showed re-accumulation of the hydrocolpos.
• Patient had a 2-cm urogenital sinus with a normal anus.
• Urogenital mobilization was performed.

Takeaways

• Characteristic ultrasound findings of hydrocolpos include a cystic structure located posteriorly to the bladder often with layering of fluid. The fluid is usually mucous and urine.
• Hydrocolpos is a common finding in patients with cloaca but also occurs in patients with urogenital sinus.
• If the urogenital sinus is longer (3 cm and greater), the anus and rectum may need to be divided in order to perform the reconstruction.
• Consent for laparotomy should always be obtained preoperatively just in case the surgery requires an abdominal approach.