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Acute urinary retention due to synechiae of the labia minora in a pediatric patient
Acute urinary retention due to synechiae of the labia minora in a pediatric patient
Kilder N. García-Murga 1 
, Luis J. Orbegoso-Celis 1 , Zhitall M. Zuniga-Torres 2 , Wendy M. Chipa-Beizaga 1
1 Unidad de Urología Pediátrica, Hospital Nacional Edgardo Rebagliati Martins, Lima, Perú; 2 Unidad de Urología, Cirugía Pediátrica, Hospital Nacional San Bartolomé Martins, Lima, Perú
*Correspondence: Luis J. Orbegoso-Celis. Email: luis.orbegoso.c@upch.pe
Abstract
Introduction: Vulvar synechiae are defined as a complete or partial fusion of the labia minora. They generally affect girls between 3 months and 6 years old. Clinical case: A 10-year-old girl presented to the emergency department due to obstruction of a Foley catheter. She had a history of bladder dilation at another institution 2 weeks prior for acute urinary retention and unsuccessful urethral catheterization. On physical examination, a suprapubic cystostomy blocked with debris was observed, and vaginal introitus sealed by fusion of the labia minora, with a hypertrophic appearance; hymen not visible, urethra not visualized. The patient underwent surgical treatment of labia minora synechiae plus drainage of vaginal collection. Conclusions: Synechiae of the labia minora affect the quality of life of female patients, with complications involving the urinary tract. The management involves genital hygiene, topical corticoids and manual dissection under local anesthesia, and surgery in case of persistent and severe cases.
Keywords: Urinary retention. Synechiae. Vulvar diseases. Suprapubic cystostomy. Corticoids.
