Persistent labial adhesions in a reproductive-age patient masquerading as urethrovaginal fistula

Labial adhesion in a reproductive-age woman is a rare entity. A woman in her 30s presented with complaints of passage of urine and menstrual blood from the same opening since menarche. The patient underwent some corrective surgery for the same, but the symptoms did not resolve. On MRI, a urethrovaginal fistula was suspected, and the patient came to our centre with this diagnosis. Examination revealed two small openings at the introitus, but urethral and vaginal openings were not seen separately. On vaginoscopy, labia minora fusion was suspected and separated under local anaesthesia. The urethral and vaginal openings were seen behind fused labia. The postoperative period was uneventful, and the patient was discharged on the same day. At follow-up, normal labial anatomy was present. A thorough gynaecological examination is integral in women presenting with urinary complaints, and a simple procedure under local anaesthesia can restore normal labial anatomy.