Labial fusion causing urinary incontinence in a postmenopausal female: a case report

Abstract

Urinary incontinence is not described in the literature as the presenting symptom of labial fusion. This report discusses a 72-year-old postmenopausal woman who presented with complaints of urinary incontinence and was diagnosed to have complete labial fusion. Following failure of conservative treatment with topical estrogen cream a surgical separation of the fusion was performed. The surgical therapy alleviated all incontinence symptoms.

Urinary incontinence secondary to severe labial agglutination

“…We identified eight case reports describing postmenopausal labial adhesions for a total of ten subjects [2][3][4][5][6][7][8][9]. These reports postulate that similar to the pediatric population, the thinning of the vulvar and vaginal mucosa and alkalinization of the vaginal environment from the hypoestrogenic state of menopause predisposes these patients to inflammatory and irritative conditions such as atrophic vaginitis.…”

“…It is rarely reported in adolescents and women of reproductive age and appears to be associated with a combination of local inflammation and the estrogen deficiency seen in the premenarchal age group [2]. Interestingly, there are only a few case reports [2][3][4][5][6][7][8][9] on labial agglutination in postmenopausal women, and a number of them describe associated urinary incontinence managed with variable treatments. We present our experience with the clinical presentation and successful management of a series of postmenopausal women presenting with urinary incontinence and voiding dysfunction associated with severe labial agglutination.…”

Labial Agglutination (Adhesion) in Pre-Pubertal Girls. What a Primary Care Physician Should Know?

“…Most children with minor agglutination of the labia are asymptomatic. When symptoms occur, they are often related to the urinary system and interfere with voiding, such as, dysuria or altered urinary stream, or symptoms related to the accumulation of urine behind the agglutination predisposing to vagina or urinary tract infections, requiring treatment [4,5].…”

Voiding dysfunction due to long-standing labial fusion in an elderly woman: a case report

“…Symptomatic labial fusion often presents with vulval pruritus and soreness and rarely with urinary incontinence [1,2], voiding difficulties, urinary retention [3] and dysuria.…”

“…It is standard practice to prescribe pre-and postoperative topical estrogens to these patients to alleviate atrophic changes in the epithelium and improve healing. Post-operative topical antibiotics in combination with estrogens have been used to minimize risk of infection, improve healing process and prevent recurrence of fusion [1][2][3].…”