Unclassified complex urogenital anomaly in a 3-year-old girl: Diagnostic and surgical challenges

Complex urogenital malformations are rare congenital anomalies that often escape existing classification systems due to marked anatomical variability. We describe a previously unreported urogenital malformation. A 3-year-old girl presented with ambiguous genitalia, a single perineal urogenital orifice, bilateral duplicated renal systems with complete vesicoureteral reflux, and vaginal agenesis. Endoscopy revealed a bladder dome diverticulum containing ureteral and cervical orifices. She underwent bilateral ureteral reimplantation and creation of an ileal neovagina with utero-neovaginal anastomosis, with an uneventful postoperative course. This anomaly represents a previously unreported entity and underscores the need for individualized, multidisciplinary management.