Labial Adhesion in Adulthood: A Report of Two Cases

Abstract

Labial adhesions are generally observed in the premenarchal and postmenopausal period. They are rarely seen in adulthood. Here, two labial fusion cases in the reproductive period are discussed. In the first case, 38-year-old virgin woman presented with anuria to the emergency unit. On her physical examination, labia were fused totally including periurethral area. His history revealed that she was mentally retarded and had primary amenorrhea. She had poor selfcare. On her genital examination, she had secondary sexual characteristics, including axially-pubic hair and breast development at Tanner stage-5. In her surgical treatment, the labia were overturned and a well-defined introitus was constituted. After the operation, topical estrogen prescribed. In second case, a forty-two year old woman with Behçet’s disease presented with dysuria and difficulty in voiding for about one month. Her obstetric examination revealed that she had two vaginal births. On pelvic examination, genital ulcer was determined on the labium. Besides, adhesion almost completely fused into the bilateral labia minora. For surgical treatment, manual separation technique was used under general anesthesia. After the operation, topical steroid was prescribed. Labial adhesions are observed, especially in the premenarchal period. However, they may be very rarely seen in the reproductive period due to local inflammation and circulating low estrogen levels. Topical estrogens, topical steroids, oral estrogen treatment, manual separation under anesthesia or without anesthesia, sharp or blunt dissection under anesthesia are alternative treatment methods. The success rates of these treatment methods exceed 90%. Besides, the recurrence rate varies between 4% and 20% with manual and sharp dissection methods.