Reconstruction of Acquired Labial Adhesions in a Young Adult Female Patient Using Split-Thickness Skin Grafting: A Rare Case.

Labial adhesions are rarely encountered in women of reproductive age and are more commonly seen in prepubertal girls or postmenopausal women. They are typically associated with hypoestrogenism, chronic inflammation, trauma, or cicatricial dermatoses. Thus, acquired labial adhesions without identifiable predisposing factors in reproductive-age women are rare and can pose a reconstructive challenge. These adhesions may lead to urinary, gynecological, and psychological morbidity. In this report, we present the case of a 24-year-old woman with progressive narrowing of the vaginal introitus over 5-6 months due to dense labial adhesions. On examination, dense midline fusion of the labia minora with obliteration of the vaginal opening was noted. There was no history of trauma, surgery, sexual activity, or dermatological disease. The patient had a prior history of urinary tract infection, with a positive urine culture reported at another hospital approximately two months before presentation to our center, for which antibiotics were prescribed. A comprehensive evaluation was performed, and hormonal and dermatological causes were excluded. Cystoscopy was performed, which showed a normal urethra and bladder. The patient was catheterized with a 14-French silicone catheter (Sterimed Medical Devices Pvt. Ltd., Haryana, India). Surgical adhesiolysis was performed, followed by reconstruction of the vaginal introitus using a thin split-thickness skin graft to prevent recurrence and restore normal anatomy. In the postoperative period, an impression of the vaginal cavity was taken using dental compound, and an acrylic mold was fabricated. At the six-month follow-up, there was no evidence of recurrence, and complete healing with satisfactory functional and anatomical outcomes was observed. Early diagnosis and individualized surgical management of rare presentations of labial adhesions in women of reproductive age are important to prevent physical and psychological morbidity.