Published literature suggests hydrocolpos is a risk factor for renal impairment in the long term. We present our experience.
Retrospective review between 1998 and 2017. Presentation, diagnoses, management and renal function are reported.
Of 36 cases of hydrocolpos, the diagnoses included:14(39%)-cloaca, 8(22%)-imperforate-hymen, 8(22%)-urogenital-sinus(UGS) and 6-miscellaneous.
Of the 8 UGS, 5 were isolated and 3 syndromic (congenital-adrenal-hyperplasia, McKusick-Kaufman-syndrome and Bardet-Biedel-syndrome)
Seventeen(47%) had prenatal diagnosis of pelvic cyst. Eleven(31%) patients were diagnosed neonatally. Hydrocolpos developed late (3months-15years of age) in 8(22%).
Twelve(12/17)of the prenatal pelvic cysts had associated prenatal upper-tract-dilatation(UTD). Three underwent antenatal drainage, one persisted postnatally and two with polyhydramnios developed UTD postnatally.
Upper tract dilatation was the most common association 20(56%).
Hydrocolpos was drained in 32(89%):vaginostomy=15,indwelling catheter=1,clean-intermittent-catheterization=6,division of transverse-vaginal-septum=2 and incision of hymen=8. Of these,3 received simultaneous urinary drainage: suprapubic cystostomy=2 and bilateral nephrostomies=1.
Pre-intervention creatinine was available for 21. Five had abnormally high creatinine. Creatinine values and upper tract dilatation normalized following drainage of hydrocolpos in all.
One of 4 patients with neurogenic bladder had ESRD and renal transplantation. Another with bilateral renal-dysplasia underwent renal transplantation. Among the rest, eleven patients had long-term follow-up (range 30-181 months, mean ± SD 86 ± 56 months) and no renal impairment was noted.
Cloacal anomaly is the commonest cause of hydrocolpos and UTD is the commonest consequence. Hydrocolpos in early life does not seem to have long-term renal sequelae provided it is appropriately managed.