Female Hypospadias and Urinary Incontinence: Surgical Solution of a Little-Known Entity

Female hypospadias is a rare genito-urinary anomaly, often associated with other congenital malformations of the urinary tract. For female hypospadias it is meant a condition in which the external urethral meatus opens high up in the anterior vaginal wall proximal to the hymenal ring; the urethra is obviously shorter than usual. Embryologically, it is thought to be due to an abnormal development of the urogenital sinus or to a lack of differentiation of Wolff’s tissue. Etiology though still remains unknown. Even though commons symptoms related to female hypospadias include urinary incontinence, recurrent urinary tract infections and dyspareunia, patients are often diagnosed accidentally during catheterization for other reasons. Its detection is simple but often late in childhood or even in adulthood. Treatment can be difficult due to the lack of consistent literature on the topic and also because it requires management of the other associated anomalies. We describe the case of a 5-year-old girl presenting incontinence secondary to hypospadias, successfully treated with a 2-step surgical strategy.