Pyocolpos Presenting as Obstructive Uropathy in a Six-week Infant: Challenges of Diagnosis and Management

Abstract

Background: Urinary obstruction is a rare finding in females. When it occurs, it is usually due to an extrinsic obstructive cause. Pyocolpos is an uncommon cause of obstructive uropathy in children.

Case report: We report the case of a six-week-old infant who presented to our facility with features of urinary obstruction due to pyocolpos. Diagnosis was quite challenging with repeated ultrasound scans. She was later discovered to have distal vaginal atresia as a cause of pyocolpos. She had an initial tube vaginostomy to drain the pus and was subsequently offered a vaginoplasty which was complicated by a rectovaginal fistula being managed expectantly.

Conclusion: The diagnosis of pyocolpos is usually missed and therefore requires a high index of suspicion.