A Rare Case of Acute Post-Coital Vulva Haematoma in a Primegravida with Acute Urinary Retention Managed at Mbale Regional Referral Hospital in Eastern Uganda a Case Report

Collins Nabulili, Denis Okidi, Julius Nteziyaremye*

Received : June 09, 2026 | Published : June 29, 2026

Citation: Nabulili C, Okidi D, Nteziyaremye J. A Rare Case of Acute Post-Coitus Vulva Haematoma in a Primegravida with Acute Urinary Retention Managed at Mbale Regional Referral Hospital in Eastern Uganda a Case Report. J Surg Pract Case Rep. 2026;2(2):1-4.

Abstract

Background
Genital trauma is common in gynaecologic practice and causes tend to differ depending on the age of the patient. Although Vulva haematoma is more common in Obstetrics with an incidence of 1-2 per 1000 deliveries, there are a rare occurrence in Gynaecology with incidence of 3.7%, and constitute 0.8% of all gynaecological emergencies. We present a rare case of post-coital vulva haematoma with acute urinary retention in pregnancy that was successfully surgically managed with subsequent positive pregnancy outcome.

Methods
We present a case of a 19year old, NA. She was a black African Ugandan, primigravida at 21 weeks of amenorrhoea. She presented with a 16hours history of post-coital painful genital swelling and acute failure to pass urine.

On examination, abdominal findings revealed a symphysis-fundal height corresponding to 22 weeks of amenorrhoea, distended urinary bladder and a tender cystic left vulvar swelling extending to involve the labia minora on the right.

On day two, the mass was noted to have increased in size with necrotic edges.

Management: Involved surgical evacuation of the haematoma with insertion of the catheter drain. She healed well and had Cul de sac catheter drain removed on day 6 and urethral catheter removed on day 8. She was enrolled into antenatal care.

Conclusions
Gynaecology emergency attendees must be suspicious of the rare causes of vulvar haematomas such as coitus and exclude them from common ones such as Bartholin’s abscess and cysts, vulva varicosities and folliculitis.

Although vulva haematomas can be managed conservatively, those that are tender, increasing in size and debilitating need surgical intervention and the procedure is safe in pregnancy.

Keywords: acute urinary retention, primegravida, post-coital, vulva haematoma.