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Urogenital Sinus: Types, Causes, Symptoms, Diagnosis and Treatment

Aug 18, 2023

Urogenital sinus

Urogenital sinus is a birth abnormality in which the urinary and reproductive tract of a girl child develops early in fetal life. The developing baby's digestive, reproductive, and urinary tracts typically share a cavity and an aperture for a brief period of time. 

But as your pregnancy progresses, these three tracts separate and each creates its own entrance. The bladder, rectum, and vagina of a baby girl typically establish their own distinct paths before exiting the body.

Urogenital sinus, also known as persistent urogenital sinus, is a condition in which the urethra (the "exit tube" for urine) and vagina (the "birth canal") continue to share a common passageway with a single opening rather than developing their own separate openings. The cloaca is the name for the shared channel with a single opening.

In brief, if your baby girl has urogenital sinus at birth, she only has two "openings," a rectum where stool ("poop") comes out, and a shared opening for the vagina and urine escape.

Types Of Urogenital Sinus

Urogenital sinus problems come in "low-joined" and "high-joined" varieties.

  • In "low joined" situations, the shared segment is short and the point at which the urethra and vagina converge into a single shared channel is low (nearer to the exit out of the body). The size and position of the urethra and vagina are both generally normal.
  • In "high joined" situations, the urethra and vagina unite at a location higher up the channel (far from the exit out of the body), and the shared part is longer. Because more severe consequences could arise, this condition is more serious. Additionally, the anus may be placed too far forward.

Cause Of Urogenital Sinus

There are times when the cause of urogenital sinus is unknown. It can occasionally be caused by a disorder called congenital adrenal hyperplasia (CAH), in which one or both of a person's adrenal glands fail to generate the enzyme required for hormone development. Baby males and girls both experience this issue, although girls are more likely to have genital organs that are abnormally formed as a result.

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Signs Of Urogenital Sinus

Specific signs could include:

  • Only one hole for the vagina and one additional opening for both the stool and pee to exit the body.
  • Abnormal vaginal closure or absence of vagina
  • The uterus, ovaries, or fallopian tubes have not fully developed.
  • The bladder's or the rectum's development may differ.

Diagnosis Of Urogenital Sinus

Choosing a course of treatment for urogenital sinus requires an accurate diagnosis. Not just your child's genitalia can be impacted by the illness, but also their entire growth and development.

During a prenatal ultrasound, urogenital sinus can occasionally be identified. Typically, it is identified during the first examination of your newborn, which occurs soon after birth. In order to find out more about her general health and any hereditary problems, your doctor will often request blood testing. She might also be examined by a specialist that the provider consults.

Additional studies, including blood work, can reveal more details about the size of the urogenital sinus. A few of these tests are:

  • Ultrasound: This procedure sends high-frequency sound waves through the body's tissues. The echoes are captured and then used to create photographic or video images of the body's internal organs. This examination identifies any kidney, bladder, vaginal, or rectum issues. It may also reveal whether the birth abnormality has caused any edema or urine accumulation.
  • Retrograde genitogram: X-rays of the region are taken after injecting dye into the vagina and common urethra. The dye aids in defining the tissues and organs so that their size, shape, and placement can be viewed clearly.
  • A test called magnetic resonance imaging (MRI) creates highly precise images of the human body without the use of X-rays by utilizing a big magnet, radio waves, and a computer. The doctor may request an MRI on newborns with urogenital sinuses to examine the pelvis and spine and check for any other issues.
  • Endoscopy: A special camera is put into the vagina or common urethra to view the anatomy.

Treatment Of Urogenital Sinus

The only approach to treat urogenital sinus is to have your baby's vagina and urethra surgically separated. The most common procedure a surgeon will select for "low joined" patients is a "flap vaginoplasty." In this treatment, two distinct holes from the body are made, one for the urethra and one for the vagina.

A more involved procedure known as a "pull-through vaginoplasty," in which the vagina is separated from the common opening and made into its own entity, is typically performed by the surgeon for "high joined" cases. Urine will continue to empty via the former common aperture after the opening has been sealed. A urogenital mobilization combined with a flap vaginoplasty is another treatment.

A clitoroplasty and/or labiaplasty may also be necessary for some female patients. To construct a more conventional clitoris, clitoroplasty includes altering tissue. In order for the patient to enjoy a good sex life as an adult, the nerves are preserved as much as possible. In a labiaplasty, the "lips" that enclose the vagina are reshaped.

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