暂无摘要。

Labial adhesion (LA) and vaginal destruction are very rare conditions in women. We report a 40-year-old woman with severe LA and distal vaginal stenosis after a radical hysterectomy at the age of 35. Completely destruction of vaginal epithelium, severe recurrent LA, voiding symptoms, and chronic pelvic pain occurs for her due to the repeated vaginal dilatation and low estrogen level. A combination of ileal vaginoplasty (IV) and labia majora flap was used in two surgical stages for treatment. After surgery, the patient\'s urinary symptoms and pelvic pain were relieved and she was able to have sex with her partner.

Labial fusion or labial adhesion can rarely be encountered postmenopausal and may be diagnosed in advanced stages especially in sexually inactive women. It may be a rare cause of voiding dysfunction or urinary retention. We present a case of a postmenopausal woman presenting with urinary retention due to complete labial fusion. The patient was treated both with topical estrogen and surgical separation of labial fusion. No recurrences developed after the procedure. Topical estrogen treatment may not resolve adhesions in postmenopausal women and invasive procedures may be necessary to resolve urinary retention.

Labial adhesion is characterised by complete or partial fusion of the labia minora. It occurs rarely in postmenopausal women. Although various methods have been proposed, there is no established treatment for postmenopausal patients with labial adhesions due to its low prevalence in this age group. Severe cases require surgical intervention, and the postoperative recurrence rate is relatively high at 14-20%. In this study, a novel therapeutic method was designed to treat labial adhesions: a combination of Z- and Y-V-plasty. An 82-year-old woman was diagnosed with severe long labial adhesion during an episode of urinary tract infection. The labia could not be separated manually; hence, Z-plasty was performed on the ventral side and Y-V-plasty on the anal side under general anaesthesia. No recurrence was noted eight months postoperatively. This method is relatively easy and produced the desired therapeutic effect with decreased risk of recurrence. This is a novel approach for postmenopausal patients with severe labial adhesion.

暂无摘要。

Labial minora fusion persisting to the reproductive age is a rare type of labial fusion. Only 17 sporadic case-reports have been published to describe this disease. We report a retrospective cohort study of nine patients undergone surgical dissections in our hospital with labial minora fusion of reproductive age. General information, a medical history, gynecological examinations, preoperative ultrasonography and observations during surgery were reviewed. Four patients found vulva deformity at age 1.25 ± 1.09 years, and the remaining 5 patients discovered the disease when they reached child-bearing age (25.20 ± 4.31). The average age of operation was 22.89 ± 6.21 years. The characteristic symptoms of the disease were menstrual blood and urine excretion from the urethral orifice. No endometriosis was detected in all 9 patients. One patient was found to have congenital defects, with a double cervical and complete uterine septum. All patients recovered well without re-adhesion. Seven patients (7/9, 77.80%) were interviewed by telephone. Three patients had normal sexual life and all patients were able to control urination normally. This labial fusion was found in 44.44% patients shortly after birth and might combined with other defects, suggesting a congenital nature of the disease, and further indicates the developmental feature of the vulva.

OBJECTIVE: Although various treatment options have been proposed for the treatment of labial adhesions, there are currently no clearly outlined limits on the duration of topical therapy, amount of lateral traction to apply, and methods to decrease the recurrence. This clinical trial was undertaken to assess the need for estrogen for treatment of prepubertal labial adhesions.
METHODS: Randomized, double-blinded, controlled trial.
METHODS: Pediatric and Adolescent Gynecology Clinic at a children\'s hospital in a metropolitan area.
METHODS: Prepubertal girls ages 3 months to 12 years with labial adhesions.
METHODS: Lateral traction with topical estrogen or topical emollient.
METHODS: The primary outcome was resolution of labial adhesions. The secondary outcome was the change in severity of labial adhesions over time between the 2 groups.
RESULTS: Forty-three girls were enrolled and 38 (88%) completed the study. The difference in complete resolution between the topical emollient group (19%) and the topical estrogen group (36%) was not statistically significant (P = .21). There was a statistically significant decrease in severity of labial adhesions over time, with the magnitude of improvement favoring the topical estrogen group.
CONCLUSIONS: Although labial adhesion severity decreased when treated with lateral traction and topical emollient or topical estrogen, the magnitude of the effect was significantly greater for topical estrogen.

Labial adhesion is a rare condition in reproductive-aged women. There are only a few reported cases of labial adhesion in this period of woman\'s life. We herein, present a case of a 22-year-old G1P1 woman with a thick and fibrous labial adhesion. The labial adhesion was excised, and the labial mucosa was sutured under local anaesthesia. Her hormonal profile (FSH, LH and estrogen levels) was found to be normal. The patient was later diagnosed with systemic lupus erythematosus (SLE) by a rheumatologist. It is the first case report that shows a relationship between SLE and labial adhesion.

Vulvovaginitis is one of the most common gynecological complaints presenting in the pediatric and adolescent female. The common causes of vulvovaginitis in the pediatric patient differ than that considered in adolescent females. When a child present with vulvar itching, burning and irritation the most common etiology is non-specific and hygiene measures are recommended. However these symptoms can mimic more serious etiologies including infection, labial adhesion, lichen sclerosis, pinworms and foreign body must be considered. Yeast infection is rare in the pediatric population but common in the adolescent. In the adolescent patient infections are more common. Yeast and bacterial vaginosis are commonly seen but due to the higher rate of sexual activity in this population sexually transmitted infections must also be considered.

Labial adhesion is a preliminary surgical lip approximation used in the early management of unilateral and bilateral cleft lip and palate. Our objective was to evaluate its effects on the maxillary arch dimensions and nasolabial esthetics by means of a systematic review. The literature search (1955-2016) was based on MEDLINE via PubMed, Web of Science, EMBASE, and the Cochrane Library. Studies with labial adhesion as a single preliminary step for definitive lip closure, in combination with nasoalveolar molding or in combination with infant orthopedics were considered eligible. Fifteen articles were identified (1978-2015), including 587 patients who underwent labial adhesion. Reduction in alveolar cleft width was between 60.9% and 100% in unilateral cases and between 47.5% and 100% in bilateral cases. Reduction in palatal cleft width was between 28.4% and 59.8% in unilateral cases and between 37.5% and 50.5% in bilateral cases. No conclusive results could be drawn about the effect on nasolabial esthetics. This systematic review comprises the available literature of the last 50 years about labial adhesion. It showed reduction of alveolar and palatal cleft width after a treatment with labial adhesion with or without infant orthopedics. The treatment effect on nasolabial esthetics, especially in the long term, remains unclear.