Labial Synechia vs. Urogenital Sinus in Adrenogenital Syndrome
Left picture: The diagnosis is a synechia of the labia minora which in severe cases leads to an obstruction of micturation and to a retrograde voiding of urine into the vagina. This causes a wetting of the panties after every micturation; often, a chronic vulvovaginits with vaginal fluor is encountered. Right picture: In this female toddler with an adrenogenital syndrome a urogenital sinus is present on account of a moderate masculinization. Depending on the level of the division of urethra and vagina, urine flows retrogradely into the vagina during every micturation and leads to wetting of the panties. Look at the endoscopic picture at the bottom with diffferent views on the site of forking of the urogenital sinus. Therefore, in every case of enuresis it is important to precisely examine the external genitals and the family history.
Left picture: Female toddler who still has an enuresis during daytime, and micturation difficulties. Instead of normal external genitals with definable labia minora and a free view of the introitus of the vagina, a dark-red furrow is recognizable in the midline from the clitoris prepuce to the perineum. Right picture: In this toddler a V-shaped orifice tapering to a point is visible instead of labia minora and a vestibule. Micturation is certainly not hindered, but an enuresis during daytime is still present.