Labial adhesion is defined as flimsy or dense fusion of labia minora in the middle which may be congenital or acquired. These adhesions are usually seen in prepubertal girls but rarely in postmenopausal women. Management options include topical estrogen with or without steroids or surgery in persistent circumstances. The case reported here was an 83-year-old postmenopausal woman who was presented with urinary retention and recurrent urinary tract infections. On examination, she had complete labial fusion leaving only a pinhole opening for voiding. A surgical approach was performed via a midline incision and complete excision of bilateral labia minora. Her urinary complaints were dissolved. Surgical management options for postmenopausal complete labial fusion cases will be discussed.