Unusual case of continuous urinary dribbling in a young female due to unknown complex urogenital malformation: Magnetic resonance features

Abstract

Congenital anomalies of kidney and urinary tract (CAKUT) occur in up to 3.2% of infants, and in almost one third of cases they are associated to genital aberrations. DMSA renal scintigraphy is considered the gold standard in CAKUT patients, to assess renal function, depict and locate ectopic kidney and to guide eventual surgical management. Recent cases have shown the noticeable limit of scintigraphy in detecting poorly functional renal moieties and associated genital anomalies; thus leading to a substantial delay in therapy, and, in females, to severe uro-gynecological complications. We herein describe a case of a young girl with unusual urinary dribbling, where DSMA scintigraphy was not diriment. MRI provided correct diagnosis of both CAKUT and IHVIRA syndrome, being crucial for patient’s management and short and long-term outcome. This preliminary experience suggests that MR can be fully feasible for detecting congenital anomalies of kidney and urinary tract along with associated genital malformations, and that it can be a better alternative to DSMA scintigraphy, especially in such a vulnerable population, and when delay in diagnosis of gynecological associated aberrations could be life-threatening or could attempt to future fertility.