Vulval adhesions causing urinary incontinence

Parkinson, D. J.; Alderman, Brian

doi:10.1136/pgmj.60.707.634

Postgraduate Medical Journal

1984

DOI: 10.1136/pgmj.60.707.634

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Vulval adhesions causing urinary incontinence

D. J. Parkinson

Brian Alderman

Abstract: SummaryAn elderly patient complained of urinary incontinence which was found to be due to vulval fusion. Surgical division followed by local oestrogen cream was curative.KEY WORDS: urinary incontinence, vulval fusion, surgical division. IntroductionA severe degree of vulval fusion is rare and only 4 previous cases have been reported with urinary incontinence as the main complaint. We report a fifth case in which surgical division of the adhesions, followed by the local application of oestrogen cream, cured the… Show more

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“…It will be useful if the authors provide a logical explanation for the relation between dividing the labial adhesion and the cure of stress urinary incontinence. Also, it is important to emphasis the local application of oestrogen creams following division as this may help in preventing further recurrence [3]. …”

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Labial fusion causing urinary incontinence: comment

Mahran

Oligbo

2011

Int Urogynecol J

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Dear Editor, We read with interest the recent case report by Dirim and Hasirci, which concluded that dividing the labial fusion can completely alleviate all urinary symptoms [1]. Indeed, there is a body of evidence to support the surgical division of labial adhesion to treat the pseudo-incontinence in postmenopausal women [2].In current practice, usually the regular vaginal examination is not performed in routine follow-up visits, which may lead to under-diagnosis of such cases. The lesson is clear: regular examination is crucial to provide good medical care.In our experience we had a similar case, and division of adhesions did help to alleviate the symptoms of retention and recurrent urine infection, but not the stress urinary incontinence, as the authors addressed in their case report. It will be useful if the authors provide a logical explanation for the relation between dividing the labial adhesion and the cure of stress urinary incontinence. Also, it is important to emphasis the local application of oestrogen creams following division as this may help in preventing further recurrence [3].

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confidence: 99%

Labial fusion causing urinary incontinence: comment

Mahran

Oligbo

2011

Int Urogynecol J

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Characteristics Among Premenarchal Girls With Lichen Sclerosus

Wang

Arlen

Vash‐Margita

2020

J Low Genit Tract Dis

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Objectives Lichen sclerosus (LS), a chronic inflammatory dermatosis localized in the anogenital region, is known to be associated with lower urinary tract symptoms (LUTS) in postmenopausal women; however, there is a paucity of data on prepubertal girls. We sought to characterize the relationship between LS, LUTS, and constipation among premenarchal girls. Materials and Methods We conducted a retrospective chart review of premenarchal girls presenting at the pediatric adolescent gynecology and pediatric urology clinics at our institution diagnosed with vulvar LS during a 4-year period. Demographics, clinical presentation, time from onset of urinary and/or bowel symptoms to LS diagnosis, and treatment response were assessed. Analysis was completed using median, range, and nonparametric statistical analysis where appropriate. Results Nineteen premenarchal girls with LS met inclusion criteria. The median age at LS diagnosis was 6.2 years (range = 3.3–13.3 yrs). Most girls (12/19, 63.2%) presented with LUTS during LS evaluation, and 11 (57.9%) of 19 patients had constipation. Pruritus and hypopigmentation were the most frequently encountered LS symptom and sign, respectively. Fourteen (73.7%) of the 19 girls had resolution/improvement of LS symptoms after LS treatment. Of the 12 patients with LUTS, 7 (58.3%) had resolution/improvement of LUTS symptoms, 3 (25.0%) had unchanged voiding symptoms, and 2 (16.7%) had unknown changes. Conclusions Although further studies are needed to better characterize the relationship between LUTS, constipation, and LS, our findings suggest that premenarchal subjects presenting with LUTS should be assessed for LS. Likewise, patients presenting with LS should be assessed for LUTS and constipation.

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Labial Fusion Causing Voiding Difficulty and Urinary Incontinence

Ong

Dwyer

1999

Aust NZ J Obst Gynaeco

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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.

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Vulval adhesions causing urinary incontinence

Cited by 3 publications

References 4 publications

Labial fusion causing urinary incontinence: comment

Labial fusion causing urinary incontinence: comment

Characteristics Among Premenarchal Girls With Lichen Sclerosus

Labial Fusion Causing Voiding Difficulty and Urinary Incontinence

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