Genital lichen sclerosus with complete introital obliteration presenting with chronic urinary retention

Lichen sclerosus (LS) is a chronic inflammatory dermatosis with predilection for the anogenital region. Progressive scarring may cause labial adhesions, introital stenosis and in advanced cases, complete obliteration with urinary obstruction. We report a postmenopausal woman with hypothyroidism who presented with chronic urinary retention due to LS-related introital fusion. Surgical adhesiolysis and urethral calibration restored normal voiding. This case underscores the severe sequelae of untreated LS, the value of early diagnosis and the importance of long-term follow-up to prevent recurrence and malignant transformation.