An interlabial mass-like lesion in an otherwise healthy newborn girl

Abstract

Examination of a term baby girl born by emergency caesarean section for fetal distress was remarkable for labial swelling (Figure 1A). Exploration of interlabial space following labial traction revealed an ovoid-like soft orange-yellow coloured mass-like lesion covered with superficial capillary vessels (Figure 1B). Vaginal introitus was identified by catheterization (Figure 1C); however, urethral meatus was not detected and its catheterization was unsuccessful. Baby was admitted to the Neonatal Intensive Care Unit with provisional diagnosis of interlabial mass to rule out urinary obstruction. An urgent focused ultrasound within first hour of life, concern of nonidentifiable urethral meatus, showed: empty bladder without any evidence of hydronephrosis or duplication; lower urethra was not visualized. Subsequently, she voided spontaneously and her urine output remained adequate throughout admission. Diagnosis was made based on clinical characteristics and review of images with paediatric urologist. Subsequently, she was discharged home on day 2 of life with an otherwise normal examination. Partial resolution of lesion was first noted on day 4 of life when she was seen by a paediatric urologist. Upon the follow-up visit at 2 weeks of life, full resolution without any remnant was noted (Figure 2).