Case Report

Complete Labial Adhesion in a Post-Pubertal Girl: A Case Report

Abstract

Labial adhesion usually occurs in the infancy period and in prepubertal girls. It is a rare entity in reproductive age without any hypoestrogenism condition. Voiding dysfunction is a rare manifestation of these conditions. Here, we report a 19-year-old girl with complete labial adhesion presented with urinary retention. A 19-year-old virgin girl was referred to the obstetrics and gynecology department of Ghaem Hospital. She complained of urinary retention. Physical examination was normal except that was moderate hypogastric tenderness and a huge vesical globe. Genital examination revealed complete fusion of the labia minora in the midline, extended from the posterior fourchette to the region of the clitoris covering the entire vaginal introitus, urethral meatus, and clitoris. Despite the use of topical estrogen cream and surgical labial separation, re-adhesion occurred for the third time. Vulvar biopsy confirmed severe inflammation. Finally, topical anti-inflammatory medication improved the symptoms. Although labial adhesion is very rare in the post-pubertal period, it can successfully be managed by medical and surgical treatment.

1. Erdoğdu E, Demirel C, Tahaoğlu AE, Özdemir A. Labial fusion: A rare cause of urinary retention in reproductive age woman and review of literature. Turk J Urol 2017;43:98-101.
2. Watanabe T, Matsubara S, Ikeda T, Kawai S, Nakamura S, Nakai H. Labial adhesion causing voiding but not sexual problems in a married woman. J Obstet Gynaecol Res 2013;39:415-9.
3. Saberi N, Gholipour F. Extensive Labial Adhesion Causing Voiding Urinary Symptoms in a Postmenopausal Woman: A Case Report. Iran J Med Sci 2020;45:73-5.
4. Kumar RK, Sonika A, Charu C, Sunesh K, Neena M. Labial adhesions in pubertal girls. Arch Gynecol Obstet 2006;273:243-5.
5. Berek JS. Berek and Novak's Gynecology. In: Adams Hillard PJ. Pediatric and Adolescent Gynecology. 16th ed. United States: Lippincott Williams & Wilkins (LWW); 2019:175.
6. Byun JM, Jeong DH, Kim YN, Lee KB, Sung MS, Kim KT. Labial adhesions caused by Stevens–Johnson syndrome. Dermatologica Sinica 2015;33:239-40.
7. Jones HW, Rock JA. TeLinde's Operative Gynecology. In: Sankey HZ, Burkman RT. Surgery for Benign Vulvar Conditions. 12th ed. Philadelphia: Wolters Kluwer; 2019:273-4.
8. Williams C, Robinson J, Leggio S. Potential effects of postmenopausal labial agglutination on the urinary system. Urol Case Rep 2021;36:101565.
9. Bacon JL, Romano ME, Quint EH. Clinical Recommendation: Labial Adhesions. J Pediatr Adolesc Gynecol 2015;28:405-9.
Files
IssueVol 60, No 1 (2022) QRcode
SectionCase Report(s)
DOI https://doi.org/10.18502/acta.v60i1.8330
Keywords
Labial adhesion Reproductive age Urinary retention

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Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Maleki A, Pourali L. Complete Labial Adhesion in a Post-Pubertal Girl: A Case Report. Acta Med Iran. 2022;60(1):64-66.