Background: The diagnosis of distal vaginal atresia is rare in the neonate unless the hydromucocolpos was developed. Pyuria and pyometrocolpos may complicate hydromucocolpos, it may present with severe obstructive uropathy and septicemia.

Aim:  to evaluate the role of combinations of clinical, microbial and immunological parameters in enhancing and to discuss the management strategies.

Patients and Methods: Twenty-eight patients presented to the pediatrics surgery ward with clinical signs of congenital distal vaginal obstruction were prospectively studied and compared with 20 healthy control group. The clinical records and radiological findings together with laboratory findings were reviewed. Urine sample collected for enzyme-linked immunosorbent assay to measure the urinary levels of interleukin IL-4, IL- 6, IL-8 and IL-10 and for macroscopically examination and culture.

Results: There was a significant rising in the immunological biomarkers in all patients group as compared with control group regardless they have associated anomalies or not, and significant correlation between IL-6, IL-8 and TNF-α rising scores with patients already presented with obstructive uropathies.

Conclusion: Pyuria associated pycolpos in congenital vaginal obstruction is a marker for underlining urinary tract abnormalities.This should rise management strategies with early picking up the pathology promoting optimal outcome.

Keyword: Pyuria, Pyocolpos. Obstrective uropatheies, Proi-mflammatory cytokine.

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