Severe Labial Fusion as a Cause of Voiding Dysfunction in a Young Woman: Report of a Case

We describe a 21-year-old female who suffered from voiding difficulty, incomplete voiding sensation and a small-caliber urinary stream for 6 months. She had menarche at 12 years of age, and denied any history of trauma, sexual abuse, intercourse or genital tract infection. Her uterus and both ovaries were anatomically normal as evidenced by abdominal sonography. Intravenous pyelography showed a normal urinary system. Uroflowmetry showed a flattened curve with 2 ml/sec of maximum flow rate (Qmax). While attempting to catheterize her bladder for urodynamic study, severe labial fusion with a pinpoint opening was mistaken for urethral orifice. She received two weeks of local premarin cream application but the symptoms persisted. After labial reconstruction, she has had no more voiding dysfunction.