[Per-urethral coitus. One case followed by pregnancy]

Area of Science:

• Reproductive Medicine
• Urology
• Gynecology

Background:

• Vaginal atresia, a rare congenital anomaly, presents unique challenges in reproductive health.
• A punctate hymenal orifice can mask underlying anatomical abnormalities.
• Understanding atypical reproductive pathways is crucial for comprehensive patient care.

Observation:

• A case of intravesical coitus through the urethra in a woman with previously unnoticed vaginal atresia.
• Pregnancy occurred despite the severe anatomical limitation, suggesting potential for external insemination.
• Surgical intervention (hymenotomy) and pregnancy exacerbated pre-existing urinary incontinence.

Findings:

• Intravesical coitus via urethra is a documented, albeit rare, occurrence in vaginal atresia.
• Pregnancy is feasible even with significant vaginal obstruction.
• Urinary incontinence, particularly without concurrent cystitis, is a frequently reported complication in 18 reviewed cases.

Implications:

• Highlights the importance of thorough gynecological and urological assessment in cases of suspected or confirmed vaginal atresia.
• Suggests that reproductive potential should be considered even in complex anatomical scenarios.
• Emphasizes the need for managing urinary incontinence associated with vaginal atresia and its treatments.