Voiding dysfunction due to long-standing labial fusion in an elderly woman: a case report

Abstract

Labial adhesions or fusion in the elderly are rare, and only few cases are described in the English literature. We describe a case of near-complete labial fusion in an elderly woman presenting with voiding difficulty, its management and literature review.

Bladder outlet obstruction due to labial agglutination

“…2,3,6 Muppala and Meskhi described a 74-year-old woman with labial fusion who complained of a "popping sensation" in the vulva when sneezing or coughing. 3 Julia et al reported the case of a 72-year-old woman with labial fusion who also presented with a paraclitoral seborrheic cyst. 2 Both of these cases were menopausal women who presented with voiding difficulties and were initially diagnosed with urinary tract infections.…”

“…Local trauma, lichen sclerosis, and recurrent urinary tract infections can also contribute to labial agglutination. 3 Even though labial agglutination is rare and often manifests with nonspecific emptying symptoms, it can be easily diagnosed on physical examination and successfully treated by surgical intervention and the application of local estrogen. Here, we present the case of a woman who suffered from nonspecific emptying symptoms and was diagnosed with delayed labial agglutination following a physical examination.…”

A rare case of urocolpos

“…5,7 In postmenopausal woman complete labial fusion will present with recurrent urinary tract infection, retention and incontinence. 6,8 Adhesions of the labia are extremely rare in the reproductive population with only a few cases described in the literature, if present may cause coital and voiding difficulty. 2,9 Post-menopausal woman with adnexal mass and abdominal pain due to fusion of the labia majora which was diagnosed as a pyosalpinx secondary to long standing urocolpos has been recorded in literature.…”

Labial fusion presenting as voiding dysfunction and pseudoincontinence

“…It is commonly seen in premenarchal girls in the first 2 years of life and post-menopausal women. [1][2][3][4][5][6][7] There appear to be a small number of cases describing the phenomenon in the literature. The etiology is thought to be a chronic irritation followed by inflammation of the vulval skin primarily due to a lack of estrogen.…”

“…The etiology is thought to be a chronic irritation followed by inflammation of the vulval skin primarily due to a lack of estrogen. 1 Other causes include trauma, lichen scleroses, lack of sexual activity, childbirth related trauma and recurrent urinary tract infections.…”