Congenital prepubic sinus: a case report

Introduction and importance: Congenital prepubic sinus is an exceptionally uncommon anomaly, with approximately 50 reported cases documented in the literature. Case presentation: A 14-year-old female presented with a lifelong whitish discharge from the mons pubis area. She had undergone prior surgery for a branchial fistula. Evaluation revealed a pinpoint opening in the prepubic area with whitish discharge, but otherwise normal external genitalia. Imaging demonstrated a sinus tract extending from the prepubic area to the anterior bladder wall. Surgical excision of the 6 cm long sinus tract was performed, and histology confirmed a congenital prepubic sinus lined by transitional and squamous epithelium. The postoperative course was uneventful without recurrence. Clinical discussion: Congenital prepubic sinus represents an uncommon midline abdominal wall anomaly, typically manifesting with purulent discharge. Definitive diagnosis involves identifying the sinus tract, which extends from the external opening to the anterior bladder wall, commonly achieved through imaging modalities such as ultrasound, fistulography, or magnetic resonance imaging. Conclusion: Simple excision is the preferred treatment in most cases. Awareness of anatomical variations is key for complete excision and preventing recurrence.