EDITORIAL COMMENT We accepted this case for publication because it gives a good account of urinary problems due to extreme labial agglutination in a postmenopausal woman. The editor was the Senior Gynaecologist in the Repatriation General Hospital, Melbournejrom 1976 to 1996, where he saw a number of elderly women with partial labial agglutination. Occasionally, when the condition was more extreme, the patients presented with spruying ofthe urine when the urinary stream hit the bridge of fused labia minora. However the editor has not seen u patient such as the woman reported here who required surgery, possibly because of routine administration of oestrogen cream to the vagina in these women. One would imagine that the process of urination would maintain a degree of labial pateizcy in these women! I t is an unfortunate fact that, even in major teaching hospitals, gynaecological conditions that are dealt with purely on an outpatient basis ure never coded and s o it is virtually impossible to do u hospital audit on the prevalence of these so-called 'minor' gynaecological disorders. This probably applies to agglutination of the labia minora in asymptomatic, elderly, postmenopausal women.Labial fusion is defined as either partial or complete adherence of the labia minora ( I ) , and has also been called vulvar fusion, adhesions of the labia minor, agglutination or conglutination of the labia minora and synechiae of the vulva. The finding of severe labial fusion is rare with a small number of cases reported in adults. We have reviewed the literature on labial fusion and present a case report of a postmenopausal woman who presented with voiding difficulty and incontinence and was treated by surgical division of the adhesions followed by local application of oestrogen cream.
CASE REPORTAn 88-year-old para 2 widow was referred with a 2-year history of symptoms of voiding difficulty and postmicturition dribbling. Her urinary stream was slow and she had to manually press abdominally on her bladder to void. Urinary leakage occurred following micturition and she had to wear sanitary pads constantly. She was not sexually active. Her past history included 2 spontaneous vaginal deliveries and a Manchester repair in 1980. She had been referred to a urologist I year previously with urinary symptoms and I . Registrar in Obstetrics and Gynaecology 2.
1 Browse NL, Whimster I, Stewart G, Helm CW, Wood JJ. Surgical management of 'lymphangioma circumcriptum'. Br J Surg. 1986 Jul; 73 (7): 585-588. 2 Fox T, Fox TC. On the case of lymphangiectodes with an account of the histology of the growth. Trans Path Soc, London. 1978; 30: 470-475. 3 Morris M. Lymphangioma circumscriptum. In: Unna PG, Morris M, Duhring LA, Leloir H, editors. International atlas of rare skin diseases. London; HK Lewis: 2. 4 Peachey RD, Lim CC, Whimster IW. Lymphangioma of the skin. A review of 65 cases.
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