Delayed Presentation of Post-Traumatic Urethrovaginal Fistula: Case Report

Objective: We present the case of a female with a history of severe pelvic injury at the age of five, who developed a fistula and vaginal stenosis 18 years later. This case underscores the importance of prompt diagnosis, thorough imaging, and consistent postoperative follow-ups. Case report: A 23-year-old female with a history of cyclic hematuria, lower abdominal pain, and difficulties with urinary and sexual activities following a severe motor vehicle accident at the age of 5 years, resulting in pelvic fractures, complete urethral transection, and vaginal lacerations. Surgery was performed, but irregular postoperative follow-up led to complications, including vaginal stenosis and cyclic hematuria coinciding with menstruation at age 12. Despite the vaginoplasty, the symptoms persisted. At 23 years of age, imaging studies confirmed the diagnosis of urethrovaginal fistula. Result: Two years after surgery, she had a normal sexual life and menstrual cycle. However, did not conceive for personal reasons and is currently on contraceptive use. Conclusion: This case highlights the delayed presentation, management, and importance of long-term follow-up, advanced imaging, and surgical strategies to achieve optimal outcomes of post-traumatic urethrovaginal fistulas in pediatric pelvic trauma.