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Total Fusion of the Labia Minora

Total Fusion of the Labia Minora 

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  #1  
12-15-2017, 01:43 AM
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Total Fusion of the Labia Minora

Two cases.

The first, is 42-year-old woman was referred for urinary incontinence, dysuria, vulvar itching, and spotting for 1 year. She had four early miscarriages, the last one 4 years prior, after which she decided to forego any further attempt at conceiving.
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  #2  
12-15-2017, 01:47 AM
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Re: Total Fusion of the Labia Minora

Ooops posted too soon the images are reversed, my apologies

On physical examination, it was impossible to identify vulvar structures: the labia minora were completely fused along the midline with burial of the clitoris and total obliteration of the vaginal introitus [Figure 1]. Urethral meatus was hidden and a pinhole orifice at the midline was the only way for the outflow of urine and menstrual blood, resulting in slow persistent dripping of menstrual blood and urine. The patient was unable to report how long it has been since the skin lesions appeared; however, she reported being sexually inactive for the last 2 years. This is the result of lichen sclerosis

The second is a patient of un known age suffering from Severe labial fusion due to advanced atrophy and lichen sclerosis

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  #3  
12-15-2017, 08:44 AM
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Re: Total Fusion of the Labia Minora

Wow, that is hideously sad. I had no idea that that type of thing was even possible.
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12-15-2017, 12:43 PM
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Re: Total Fusion of the Labia Minora

I can only imagine that these women are beyond incredibly fat. I don't know a single woman that doesn't take regular hygenic care of their lady parts that would make this issue noticeable immediately. Wouldn't you be able to just look down realize something wasn't right?
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12-15-2017, 04:33 PM
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Re: Total Fusion of the Labia Minora

Anyone know her phone number?

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12-15-2017, 04:38 PM
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Re: Total Fusion of the Labia Minora

I can only imagine that these women are beyond incredibly fat. I don't know a single woman that doesn't take regular hygenic care of their lady parts that would make this issue noticeable immediately. Wouldn't you be able to just look down realize something wasn't right?
IKR since the urine, mensurable fluids and any other vaginal secretions are coming out of a tiny lil hole you'd think after having a vagina for 40 some odd years you'd know when something is up. Even if they never looked at it, or cleaned properly that must feel extremely weird on a day to day basis
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12-15-2017, 09:20 PM
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Re: Total Fusion of the Labia Minora

I can only imagine that these women are beyond incredibly fat. I don't know a single woman that doesn't take regular hygenic care of their lady parts that would make this issue noticeable immediately. Wouldn't you be able to just look down realize something wasn't right?
Um yeah, it's called a mirror. Stand in front of one or squat over one! I'm guessing there were no yearly visits to the gynecologist either. Nasty.
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12-16-2017, 05:54 AM
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Re: Total Fusion of the Labia Minora

  #9  
12-16-2017, 09:09 AM
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Re: Total Fusion of the Labia Minora

So it is true. If you don’t use it you lose it.
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12-16-2017, 10:25 AM
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Re: Total Fusion of the Labia Minora

India, Despite a prolonged course of topical clobetasol, clinical symptoms continued until the patient requested surgical intervention for vulvar plastic surgery and simultaneous hysteroscopic myomectomy.

After cold knife median incision, the labia were separated by digital blunt dissection of adhesions along the midline, exposing the urethral meatus behind the previously fused labia.

The narrowed vaginal introitus was easily widened by digital pressure and hysteroscopic myomectomy was performed. Soaked gauzes, changed three times daily until healing, were applied to keep the labia separated, while vaginal packing was maintained for 2 days.

The patient used anti-adhesion oily medications. One week after surgery, she was started on a regimen comprising morning applications of daily estrogen ointment, topical emollient at noon, and clobetasol ointment at night for 3 months, administered continuously three times a week.

She could resume sexual activity and micturition. At 1-year follow-up, she had no relapse.
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