A novel surgical treatment for labial adhesion – The combination of Z- and Y-V-plasty: A case report

Abstract

Labial adhesion is characterised by complete or partial fusion of the labia minora. It occurs rarely in postmenopausal women. Although various methods have been proposed, there is no established treatment for postmenopausal patients with labial adhesions due to its low prevalence in this age group. Severe cases require surgical intervention, and the postoperative recurrence rate is relatively high at 14–20%. In this study, a novel therapeutic method was designed to treat labial adhesions: a combination of Z - and Y-V-plasty. An 82-year-old woman was diagnosed with severe long labial adhesion during an episode of urinary tract infection. The labia could not be separated manually; hence, Z-plasty was performed on the ventral side and Y-V-plasty on the anal side under general anaesthesia. No recurrence was noted eight months postoperatively. This method is relatively easy and produced the desired therapeutic effect with decreased risk of recurrence. This is a novel approach for postmenopausal patients with severe labial adhesion.

Z-Plasty and Postoperative Estradiol Vaginal Tablets for Labial Adhesion with Lichen Sclerosus

“…However, even with surgical intervention, the postoperative recurrence rate is generally high, reportedly occurring in about 20% of cases 7) . For this reason, there have been reports of the application of local skin flaps, such as Z-plasty and V-Y advancement flaps, to prevent readhesion [8][9][10] and the use of postoperative wound dressing and estrogen preparations 11,12) . However, there is no consensus regarding the ideal duration or degree of efficacy of these approaches.…”