Postmenopausal complete labial fusion and pseudo-incontinence: A case series

Abstract

IntroductionPostmenopausal labial fusion constitutes a severe form of genitourinary syndrome of menopause. This report describes the management of a series of women with complete labial fusion (CLF) and pseudo-incontinence.MethodsThis is a seven-year retrospective chart review in a urogynaecology unit of a tertiary hospital of all who patients presented with CLF and lower urinary tract symptoms, predominantly continuous urinary incontinence. All patients had a standardized surgical intervention and were followed up in the outpatient department.ResultsSeven patients (mean age 72.9 ± 12.1 years) with CLF and associated pseudo-incontinence were identified from the hospital archives. All patients had an uneventful surgical restoration of the labial anatomy, the pseudo-incontinence had resolved immediately postoperatively in all cases, and no recurrence of the labial agglutination had occurred after an average follow-up of 2.4 years.ConclusionsIn this report we present a case series of seven postmenopausal patients with CLF and urinary pseudo-incontinence who underwent successful surgical management with good anatomical results and complete resolution of urinary symptoms.

Potential effects of postmenopausal labial agglutination on the urinary system

“…Methods of preventing the recurrence of severe cases of agglutination include the following: application of silicon film or hydrocolloid dressings or rotational skin flap grafting from the thigh. 4 Mikos et al 1 recommends a ‘U’ shaped excision of the agglutinated labia minora to prevent re-agglutination and removed tissue to be examined to rule out malignancy since vulvar LS increases the risk of SCC. 5 …”

“…Labial agglutination (LA) can affect prepubertal or postmenopausal women - commonly affecting prepubertal girls at a prevalence of 1.8–3.3%. 1 The rate at which LA affects postmenopausal women is unknown, with only a few documented case reports. The most common etiologies for LA are vaginal atrophy and vulvar lichen sclerosus (LS).…”

Complete labial fusion causing pseudo-urinary incontinence: A long-term sequelae of genitourinary syndrome

“…Some authors believe that labial fusion/adhesions play a role in urinary incontinence's etiopathogenesis in these types of cases. [ 5 ] Surgical correction is the treatment for CLF, and urinary symptoms resolved completely following correction of labial fusion. The challenge here is to make women adhere to local therapy and follow-up.…”

“…have shared their experience with a retrospective review of seven cases of surgical correction of CLF in postmenopausal women presenting with lower urinary tract symptoms. [ 5 ] Another series of six cases by Singh and Han reported the presentation and management of CLF in these group of women. [ 4 ] We present a case of a 68-year-old postmenopausal woman with pseudo-urinary incontinence.…”

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

“…It occurs mainly in prepubertal girls and is relatively rare in postmenopausal women [ 1 ]. The condition is related to low oestrogen levels, local chronic inflammation [ 2 , 3 ], and low sexual activity [ 4 ]. Patients with labial adhesions rarely complain of the symptoms unless the fusion is almost complete.…”