A new method of surgical treatment for recurrent labial adhesions in a pre-pubertal girl

Silva, D; Jayalath, G.K.C.; Ranaweera, Amanda; Jayawardane, Mamm; Sudeshika, M D A

doi:10.4038/cmj.v57i4.5086

Cited by 8 publications

(7 citation statements)

References 8 publications

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“…16 Apart from the routine surgical separation, alternative/additional surgical techniques include the use of amniotic membrane, rotational skin flaps, split thickness skin grafts and suturing pieces of saline infusion tubes to the raw area. 12,17,18 conclusIon Although uncommon, labial fusion can occur in the postpubertal females, one needs to have high index of suspicion to diagnose this rare condition as the patient often presents with common gynecological symptoms of difficult menstruation and urinary dribbling. This case illustrates the value of gynecological examination for the evaluation of voiding symptoms as otherwise disorders such as labial adhesion, meatal stenosis, and ambiguous genitalia may not be recognized and carries forward to the reproductive age.…”

Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Urinary Pseudoincontinence: Two Rare Cases of Labial Fusion in Adolescent and Postmenopausal Women

Murugesan¹,

Palaniappan²,

Kalaimani³

2020

Journal of South Asian Federation of Obstetrics and Gynaecology

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Labial adhesions are usually a pediatric condition and are asymptomatic. They are identified by parents or on routine examination. They can also occur in postmenopausal age group albeit uncommon due to hypoestrogenism causing senile vaginitis. Here, we have two cases of labial fusion in different age groups, 17-years-old and 65-year-old females presenting with urinary symptoms. The release of labial fusion was done under general anesthesia in both the patients. The labial adhesions are usually a pediatric condition and are asymptomatic. Although one needs to have high index of suspicion to diagnose this rare condition, as the patient often presents with common gynecological symptoms of difficult menstruation and urinary dribbling. It can also occur in postmenopausal women though uncommon, one needs to have high index of suspicion due to hypoestrogenism.

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Section: Discussionmentioning

confidence: 99%

An Unusual Cause of Urinary Pseudoincontinence: Two Rare Cases of Labial Fusion in Adolescent and Postmenopausal Women

Murugesan¹,

Palaniappan²,

Kalaimani³

2020

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…If we try to define this technique of Nurzian or the techniques used in sharp instruments as genuine surgical separation, we think it would be more accurate to define the other "surgical" techniques as a separation with instruments (SWI). Therefore, the study of Nurzian et al and studies (20) similar to the Nurzians were excluded from the evaluation when a comparison was made between the techniques.…”

Section: Discussionmentioning

confidence: 99%

Pre-pubertal labial adhesion surgery: The first study to compare manual or surgical separation

Hüseynov¹

2019

Ann Med Res

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Aim: Labial adhesion (LA) is one of the most common causes of admission to the pediatric surgery outpatient clinic among the prepubertal girls. There is no consensus on the best interventional technique (manual or surgical separation) for LA. The aim of this study is to compare the results of the manual and surgical separation of LA, and to decide which one is superior. Material and Methods: We reviewed the medical records of sixty-six patients with LA operated between July 2016 and Mart 2018 by the same surgeon. The patients were divided into two groups: patients treated with a manual separation technique (group 1) and with a surgical separation technique (group 2). Patients were evaluated regarding age at presentation, referral indication, symptoms, surgical technique, recurrence and time of recurrence. Results: There were 27 cases in Group 1 and 39 cases in Group 2. There were 14 recurrences in Group 1 (51.8%) and 5 recurrences in Group 2 (12.8%). The recurrence rate was significantly higher in Group 1. This difference between groups was statistically significant (p=0.0006). The relative risk for recurrence in Group 1 was found to be 4.0444 (OR 7.3231; p=0.0012), and 0.2473 in Group 2 with a significance level of p=0.0022. Conclusion: The treatment of labial adhesion with the surgical separation technique is superior to manual separation in terms of the possibility of recurrence. Additional prospective studies are still needed to strengthen these data.

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“…Membran genellikle ince ve transparandır ve arka kısma doğru kalınlaşır. Tekrarlayan olgularda vulvar irritasyon ve artmış epitelizasyona bağlı olarak membran daha kalındır (5,6).…”

Section: Discussionunclassified

Approaches to the Treatment of Labial Fusion

Saraç¹,

Büyükbeşe²,

Toptaş³

et al. 2016

Haseki

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Amaç: Labial füzyon, labium minoraların orta hatta kısmi veya tam yapışıklığıdır ve çocukluk çağının sık görülen bir jinekolojik sorunudur.Çalışmamızın amacı labial füzyon tanısı ile tedavi ettiğimiz hastalarda, medikal tedavi ile mekanik seperasyon sonuçlarımızın karşılaştırılmasıdır. Yöntemler: Haseki Eğitim ve Araştırma Hastanesi, Çocuk Cerrahisi Polikliniği'nde Ocak 2012 ile Ocak 2015 tarihleri arasında, labial füzyon nedeni ile tedavi edilmiş 25 hasta, tedavi yöntemi ve sonuçlarına göre retrospektif olarak değerlendirildi. Topikal östrojenli krem kullanılan 10 hasta ile manuel seperasyon yapılan 15 hasta karşılaştırıldı. Bulgular:Hastalarımızın yaşı 3-66 ay arasında ortalama 28,8 ay olarak bulundu. Toplam rekürrens oranı %28 idi. Topikal östrojen ile tedavi başarısı %60, manuel seperasyon ile tedavi başarısı %73,3 olarak hesaplandı. Her iki tedavi yöntemi arasında istatistiksel olarak anlamlı fark saptanmadı.Sonuç: Labial füzyon tedavisinde, topikal östrojen uygulamasının noninvaziv ve güvenli bir yöntem olarak ilk seçenek olması gerektiğini düşünmekteyiz. Anahtar Sözcükler: Labial füzyon, topikal östrojen, manuel seperasyonAim: Labial fusion is defined as complete or partial fusion of the labia minora in the midline. It is a common gynecologic problem in childhood. The purpose of this study was to compare the outcomes of our patients we treated either with medical therapy or mechanical separation. Methods:We retrospectively evaluated the treatment outcomes, and the treatment modality in a total of 25 patients with labial fusion who were treated between January 2012 and January 2015 in the Pediatric Surgery Outpatients Clinics at Haseki Training and Research Hospital. Results:The mean age of the patients was 28.8 months (range: 3-66 months). Recurrence was observed in 28% of patients. The success rate of estrogen therapy and manual separation was 60% and 73.3%, respectively. No statistically significant difference was found in treatment success between the treatments. Conclusion:We assume that for being a non-invasive and safe method, topical estrogen application should be the first choice for the treatment of labial fusion. GirişLabial füzyon çocukluk çağının sık görülen bir jinekolojik problemidir. Labial adezyon, labial aglütinasyon, vulva sineşisi olarak da isimlendirilir. Labium minoraların orta hatta tam veya kısmi olarak yapışması olarak tanımlanır. Prepubertal kız çocuklarının %0,6-3'ünü etkiler. En sık görülme yaşı 13-23 aydır. Etiyoloji tam olarak bilinmemekle birlikte prepubertal düşük östrojen düzeyiyle ilişkili olduğu düşünülmektedir. Hastaların çoğu asemptomatiktir. Lokal enflamasyon, üriner sistem enfeksiyonları ve obstrüksiyonları gibi komplikasyonlar eşlik edebilir. Medikal tedavide topikal östrojenli kremler genellikle ilk seçenektir. Medikal tedavi başarısız olursa manuel seperasyon veya genel anestezi altında cerrahi seperasyon uygulanır (1-4).

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A new method of surgical treatment for recurrent labial adhesions in a pre-pubertal girl

Cited by 8 publications

References 8 publications

An Unusual Cause of Urinary Pseudoincontinence: Two Rare Cases of Labial Fusion in Adolescent and Postmenopausal Women

An Unusual Cause of Urinary Pseudoincontinence: Two Rare Cases of Labial Fusion in Adolescent and Postmenopausal Women

Pre-pubertal labial adhesion surgery: The first study to compare manual or surgical separation

Approaches to the Treatment of Labial Fusion

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