Adolescent urethral coitus: 2 cases and review of the literature

Urethral coitus is a very rare finding in adolescent women. There are 26 reported cases in the literature, but only two were in adolescents. Urethral coitus has been most commonly described in women with müllerian anomalies and less commonly in other unusual clinical circumstances.

We report 2 cases of adolescent women with known müllerian anomalies who were unknowingly engaging in urethral coitus; 1 adolescent with known vaginal agenesis and VACTERL association and one 16-year-old with an oblique vaginal septum and non-communicating functioning uterine horn. Both young women had significant urethral dilation at the time of examination under anesthesia.

Urethral intercourse is rare but may have significant consequences. Ongoing follow-up, careful history, and physical examination in adolescent women with müllerian anomalies are important in order to avoid possible complications, particularly when they are contemplating sexual activity. A history of urinary incontinence, dyspareunia, and urinary tract infections in young women with müllerian anomalies should raise suspicion of urethral coitus. If possible, the müllerian anomaly should be corrected to allow vaginal intercourse and discontinuation of urethral coitus.