Urethral coitus is a rare condition seen especially in cases with vaginal agenesis or hymen imperforatus. A female patient with sexual dysfunction and primary amenorrhea diagnosed with urethral coitus is presented in this report. These cases present recurrent urinary tract infections, dysuria, and dyspareunia besides primary amenorrhea. There was no megalourethra or vaginal introitus in our case. The patient did not accept corrective operation because infertility cannot be corrected afterwards. In this report, we present a case of urethral coitus associated with vaginal agenesis.