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Case Report
Lichen sclerosus causing obstructive urinary retention and pyocolpos: A case report
1 BMed, Registrar in Obstetrics and Gynaecology, Department of Women and Children’s Health, Northern Beaches Hospital, Frenchs Forest NSW, Australia
2 MBChB, FRANZCOG, Consultant Obstetrician & Gynaecologist, Department of Women and Children’s Health, Northern Beaches Hospital, Frenchs Forest, NSW, Australia
Address correspondence to:
Georgina Davis
Northern Beaches Hospital, 105 Frenchs Forest Road West, Frenchs Forest, NSW 2086,
Australia
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Article ID: 100086Z08MV2021
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How to cite this article
Van M, Davis G. Lichen sclerosus causing obstructive urinary retention and pyocolpos: A case report. J Case Rep Images Obstet Gynecol 2021;7: 100086Z08MV2021.ABSTRACT
Introduction: Lichen sclerosus is one of the most common dermatological conditions affecting the vulva, perineum, and perianal area. The etiology is not entirely understood but appears to be multifactorial and most commonly affects women above the age of 50. Lichen sclerosus can cause extreme pruritis, pain, and loss of vulval architecture with resorption of the labia minora and stenosis of the vaginal introitus.
Case Report: An 82-year-old woman presented to the Emergency Department with lower abdominal pain and dysuria. She was found to be in urinary retention. On insertion of an indwelling catheter, severe anatomical distortion and scarring of the vulva was noted with fusion of the labia majora in the midline, stenosis of the vaginal orifice, and excoriated skin. A computed tomography (CT) scan of the abdomen and pelvis was performed as her pain persisted despite bladder emptying and was significant for a pyocolpos with a dilated vagina and ring enhancement. Examination under anesthesia and biopsies confirmed severe lichen sclerosus resulting in obstructive pyocolpos and urinary retention. The patient was commenced on ultrapotent topical steroids and remains under clinical surveillance.
Conclusion: This case illustrates a rare and important complication of untreated lichen sclerosus.
Keywords: Lichen sclerosus, Urinary retention, Vulva
SUPPORTING INFORMATION
Author Contributions
Michelle Van - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Georgina Davis - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2021 Michelle Van et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
