Congenital vesicovaginal fistula in association with hypoplastic kidney and uterus didelphys.

Abnormalities of the lower urinary and genital tracts commonly coexist, although congenital vesicovaginal fistula is extremely rare. We report the first case of congenital vesicovaginal fistula and hypoplastic kidney in association with uterine didelphys. Despite extensive investigation throughout childhood, a definitive diagnosis was not made until 16 years of age. We discuss some of the difficulties that might arise in diagnosing a small vesicovaginal fistula in the presence of a fusion abnormality of the genital tract and suggest how such cases might be investigated and managed surgically.