Acquired labial fusion mimicking congenital urogenital sinus anomaly: A case report

The diagnosis of labial fusion is sometimes difficult. Total closure of the vaginal opening because of dense adhesion can be misdiagnosed as congenital urogenital sinus or Mullerian anomaly. An incorrect diagnosis may result in the patient receiving wrong information and an inappropriate treatment. Here we report a case of labial fusion in a 34-year-old woman. She was referred with an initial diagnosis of congenital urogenital sinus anomaly (low vaginal septum). On history taking, she mentioned frequent vulvar erosion during bicycle riding in her adolescence. On physical examination, total labial fusion was noted, with only a pinpoint hole. Additionally, on ultrasound, all structures at the vulvo-vaginal area could be distinguished. Thus, a final diagnosis of labial fusion was made. She underwent appropriate surgery without any complications. In such cases, careful history taking, physical examination, and transrectal ultrasound imaging can help make an accurate diagnosis of labial fusion and help patient achieve appropriate management to relieve all the symptoms.