Purpose or Case Report: We report a case of a 7 year old female who presented to urology clinic due to recurrent urinary tract infections that had started 4 years ago. The patient also reported symptoms of urge incontinence and nocturnal enuresis beginning at the same time. She previously consulted an adult gynecologist, which showed no physical exam evidence of genitourinary abnormalities. An MRI of the abdomen and pelvis was also ordered at that time which reported a normal exam except for a small left renal cyst. At our institution she underwent DMSA renal scan, which was normal. She underwent a voiding cystourethrogram (VCUG), which showed no vesicoureteral reflux. However, during the VCUG, an incidental note was made of large amounts of vaginal reflux extending into the cervix, uterus, and with spillage into the peritoneal cavity presumably via the salpinges.
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Conclusions: Extension of contrast into the peritoneal cavity via vaginal reflux on VCUG has previously been reported only in patients with genitourinary anomalies. However, this patient had prior workup demonstrating no definite genitourinary abnormalities. This case suggests that reflux of contrast to the peritoneal cavity may be possible in patients with otherwise normal genitourinary anatomy.