[Urethral coitus due to congenital abnormality of the genitalia].

Background: Urethral coitus is rare and can arise in women who were born without a vagina, for instance in the context of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.
Case Description: A 16-year-old girl presented at the general practitioner's surgery with primary amenorrhoea. After a long diagnostic process she was diagnosed with MRKH syndrome and treatment with a vaginal dilator was started. During follow-up the patient reported pain on coitus and that she sometimes lost a lot of fluid during intercourse. It appeared that the patient had dilated her urethra, not her vagina, and that she had had urethral coitus. The patient underwent Davydovvaginoplasty without complications.
Conclusion: In patients with MRKH syndrome who experience urinary incontinence (particularly during and after coitus), recurrent urinary tract infections and dyspareunia urethral coitus should be suspected.