AP (above left) and lateral (above right) images during injection of water soluble contrast into the vagina shows a dilated vagina and a duplicated uterus. Lateral image during antegrade injection of water soluble contrast into the patient’s distal mucous fistula (below left) shows a connection between the posteriorly located distal rectum and the posterior aspect of the vagina. Lateral image obtained during filling of the anteriorly located bladder with water soluble contrast through a suprapubic catheter (below right) shows the proximal urethra just inferior to the bladder to be dilated.