Genitography, Endoscopy (DD Ambiguous External Genitals)

geni_25a_n.jpg and geni_25b_n.jpg: Genitography (= demonstration of the genital tract by contrast x-ray) of the urogenital sinus in two female patients. geni_25a_n.jpg: Lateral x-ray after retrograde contrast filling of the common distal part of the urethra; on the left side in front of the sacrum is the vagina, and in front of the latter the relatively long proximal urethra and bladder. geni_25b_n.jpg: Antero-posterior x-ray of the internal genitals with vagina, uterus, and right fallopian tube after contrast injection into the vagina starting from the urethra by a ureter catheter. geni_25c_n.jpg: Endoscopic pictures of an 11-month-old girl with a urogenital sinus. In the upper row of pictures the entry to the bladder can be seen at the top and the entry to the vagina at the bottom. geni_25a_n.jpg to geni_25c_n.jpg: The presence of a urogenital sinus can only be suspected clinically in some of the patients. For a precise diagnosis, genitography, endoscopy, and/or MRI are necessary. Depending on the site of union between urethra and vagina, different types of urogenital sinus result. Mainly in cloacal anomalies, there is a union close to the cervix or to the bladder, and the otherwise absent distal rectum enters the vagina or the bladder.