Ephemeral urocolpos: Radiological insights into a rare presentation of vesicovaginal reflux

Ephemeral urocolpos, characterized by urine accumulation in the vagina, is a rare presentation of vesicovaginal reflux, often resolving spontaneously. Its transient nature necessitates dynamic pre- and postvoid imaging. Transabdominal ultrasound of an 18-year-old obese female with intermittent postvoid urinary dribbling suggested urocolpos by demonstrating an anechoic fluid collection in the vagina that increased in size postvoid, with subsequent near-complete resolution, highlighting its transient nature. The magnetic resonance imaging corroborated this with postvoid T2-hyperintense (urine signal) vaginal distension. The computed tomography voiding cystourethrogram showed contrast reflux into the vagina during micturition, without structural anomaly or fistulous tract. Conservative management (voiding retraining) led to symptom resolution.