Skip to main content

Advertisement

SpringerLink
Log in

Labial adhesions in postmenopausal women: presentation and management

  • Clinical Opinion
  • Published:
International Urogynecology Journal Aims and scope Submit manuscript

Abstract

Labial adhesion is defined as complete or partial fusion of the labia minora in the midline through flimsy or dense adhesions. It may be congenital or acquired. Acquired cases are mainly seen in oestrogen deficiency states in prepubertal girls and postmenopausal women. Aggravating factors include chronic inflammation due to poor hygiene, eczema, lichen planus or sclerosus, seborrhic dermatitis, eczema, local trauma and recurrent urinary tract infections. Patients may be asymptomatic or present with urinary or vulval symptoms. Management in mild cases includes the application of topical oestrogen with or without topical steroids. If there is no response to topical therapy, surgical separation under anaesthesia should be performed. Herein, we report six cases of complete labial fusion in postmenopausal women who presented to our clinic with various urinary and vulval complaints. The mean age of these patients was 76 (range 61–85) years.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Chang CH, Fan YH, Tong-Long Lin A, Chen KK. Bladder outlet obstruction due to labial agglutination. J Chin Med Assoc. 2012;75(1):40–2.

    Article  PubMed  Google Scholar 

  2. Julia J, Yacoub M, Levy G. Labial fusion causing urinary incontinence in a postmenopausal female: a case report. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:360–1.

    Article  CAS  PubMed  Google Scholar 

  3. Ong NCS, Dwyer PL. Labial fusion causing voiding difficulty and urinary incontinence. Aust New Zealand J Obstet Gynaecol. 1999;39(3):391–3.

    Article  Google Scholar 

  4. Kaplan F, Alvarez J, Dwyer P. Nonsurgical separation of complete labial fusion using a Hegar dilator in postmenopausal women. Int Urogynecol J Pelvic Floor Dysfunct. 2015;26(2):297–8.

    Article  Google Scholar 

  5. Palla L, De Angelis B, Lucarini L, Spallone D, Palla G. Cervelli V. a case of labial fusion and urinary pseudo-incontinence in an elderly woman. A surgical treatment and a review. Eur Rev Med Pharmacol Sci. 2010;14(5):491–3.

    CAS  PubMed  Google Scholar 

  6. Pulvino JQ, Flynn MK, Buchsbaum GM. Urinary incontinence secondary to severe labial agglutination. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(2):253–6.

    Article  PubMed  Google Scholar 

  7. Bradford J, Fischer G. Surgical division of labial adhesions in vulvar lichen Sclerosus and lichen planus. J Lower Genit Tract Dis. 2013;17(1):48–50.

    Article  Google Scholar 

  8. Prahl R, Gebhard M, McGerald G, Klein R. The case files: a rare case of labial fusion. Emerg Med News 2014:13(2A).

  9. Savona-Ventura C. Labial adhesion in potmenopausal women with hip joint disease. Aust N Z J Obstet Gynaecol. 1985;25(4):303–4.

    Article  CAS  PubMed  Google Scholar 

  10. Muppala H, Meskhi A. Voiding dysfuction due to long standing labial fusion in elderly woman: a case report. Int Urogynecol J Pelvic Floor Dysfunct. 2009;20:251–2.

    Article  CAS  PubMed  Google Scholar 

  11. Başaranoğlu S, Doğan D, Deregözü A. Acute renal failure due to complete labial fusion: a case report. Int J Surg Case Rep. 2016;29:162–4.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Ahyan D, Eray H. Labial fusion causing urinary incontinence and recurrent urinary tract infection in as postmenopausal female: a case report. Int Urogynecol J Pelvic Floor Dysfunct. 2011;22:119–20.

    Article  Google Scholar 

  13. Madhavi J, Vibha More, Satia MN. Labial agglutination in a postmenopausal female. J Postgraduate Gynecol Obstet 2015;2(6).

  14. Dube R. An approach to women with labial agglutination at different stages of life- a review. Int J Adv Multidiscip Res. 2016;3(2):1–10.

    Google Scholar 

  15. Tsianos GI, Papatheodorou SI, Michos GM, Koliopoulos G, Stefos T. Pyosalpinx as a sequela of labial fusion in a post-menopausal woman: a case report. J Med Case Rep. 2011;5:546.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Tumbal PS, Majumdar R. Postmenopausal complete labial fusion: a rare case study. Int J Reprod, Contracep, Obstet Gynecol. 2016;5(5):1646–8.

    Article  Google Scholar 

  17. Dănău R, Petca R, Predoiu G, et al. Chronic urinary retention due to labial fusion – case report. Roman J Urol. 2016;15:47–50.

    Google Scholar 

  18. Acharya N, Ranjan P, Kamat R, et al. Labial fusion causing pseudoincontinence in an elderly woman. Int J Gynaecol Obstet. 2007;99(3):246–7.

    Article  CAS  PubMed  Google Scholar 

  19. James R, Sammarco A, Sheyn D, Mahajan S. Severe labial agglutination release in a postmenopausal woman. Open J Obstet Gynecol. 2014;4:822–5.

    Article  Google Scholar 

  20. Gopalakrishnan G, Bhatnagar A, Raju A. Complete labial fusion in a post-menopausal woman - a possible explanation. Ind J Urol. 2001;18:98–9.

    Google Scholar 

  21. Bika O. Complete labial fusion in the postmenopausal woman- a review of literature. ePoster. RCOG World Congress in Obstetrics and Gynaecology 2013.

  22. Mayoglou L, Dulabon L, Martin-Alguacil N, et al. Success of treatment modalities for labial fusion: a retrospective evaluation of topical and surgical treatments. J Pediatr Adolesc Gynecol. 2009;22:247–50.

    Article  PubMed  Google Scholar 

  23. Hatada Y. Two-step surgical approach to labial adhesions in a postmenopausal woman. Acta Obstet Gynecol Scand. 2003;82:1054–5.

    Article  PubMed  Google Scholar 

  24. Fakheri T, Saeidiborojeni H, Jalilian N, et al. Urinary retention due to labial fusion; bloodless correction. A case report. Prof Med J. 2011;18(2):328–30.

    Google Scholar 

  25. Johnson N, et al. A new surgical technique to treat refractory labial fusion in the elderly. Am J Obstet Gynecol. 1989;161:289–90.

    Article  CAS  PubMed  Google Scholar 

  26. Saito M, Ishida G, Watanabe N, Abe B. Micturitional disturbances due to labial adhesion. Urol Int. 1998;61(1):50–1.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urogynaecology, KK Women’s and Children’s Hospital, 100, Bukit Timah Road, Singapore, 229899, Singapore

    Priyanka Singh & Han How Chuan

Authors
  1. Priyanka Singh
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Han How Chuan
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Priyanka Singh.

Ethics declarations

Conflicts of interest

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Singh, P., Han, H.C. Labial adhesions in postmenopausal women: presentation and management. Int Urogynecol J 30, 1429–1432 (2019). https://doi.org/10.1007/s00192-018-3821-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00192-018-3821-1

Keywords

Search

Navigation