Background: Labial adhesion (LA) is a total or partial labial fusion mostly seen in pre-pubertal children and is rare in premenopausal and postmenopausal periods. This review aimed to evaluate risk factors for labial fusion and the recurrence rate following surgical intervention in postmenopausal women. Methods: According to PRISMA guidelines, international databases including Embase, World Cat, Web of Science, Scopus, Dimension, Open Grey, Cochrane, Google Scholar, and also PubMed gateway for PMC and MEDLINE were searched. The included studies were in English and published from 1985 until December 2023 with the keywords including vulvar diseases, agglutination, menopause, postmenopause, and recurrence. All studies that evaluated the clinical course and recurrence of LAs following surgical treatment in postmenopausal women were included. The inclusion criteria were the risk factors of LA recurrence rate, and the exclusion criteria were studies with missing required data, letters to editors, and conference studies. Results: Thirty-four case reports were enrolled. In total, 54 patients were evaluated. The most common risk factors for LA included hypoestrogenism, virginity, sexual inactivity, cervical cancer, hysterectomy, urinary tract infections, and lichen sclerosis. Only one study reported a recurrence of labial fusion following surgical intervention in a one-year follow-up. Conclusion: The most common risk factors for LA were hypoestrogenism, virginity, sexual inactivity, cervical cancer, hysterectomy, urinary tract infections, and lichen sclerosis. The low recurrence rate following surgical release of labial fusion has made it an effective and safe method in postmenopausal women with negligible medium-term recurrence rates. |
- Maeda T, Deguchi M, Amano T, Tsuji S, Kasahara K, Murakami T. A novel surgical treatment for labial adhesion - The combination of Z- and Y-V-plasty: A case report. Case Rep Womens Health. 2021;32:e00363. doi: 10.1016/j.crwh.2021.e00363. PubMed PMID: 34754757; PubMed Central PMCID: PMCPMC8556753.
- Wyman AM, Lafranchise E, Lynch C. External Use of an Oxidized Regenerated Cellulose Agent in the Treatment of Labial Agglutination in Postmenopausal Women. Obstet Gynecol. 2018;132:1238-40. doi: 10.1097/AOG.0000000000002919. PubMed PMID: 30303908.
- Gonzalez D, Anand S, Mendez MD. Labial Adhesions. StatPearls. Treasure Island (FL): StatPearls Publishing; 2023.
- Saberi N, Gholipour F. Extensive Labial Adhesion Causing Voiding Urinary Symptoms in a Postmenopausal Woman: A Case Report. Iran J Med Sci. 2020;45:73-5. doi: 10.30476/ijms.2019.81954. PubMed PMID: 32038062; PubMed Central PMCID: PMCPMC6983273.
- Takemaru M, Aramaki-Hattori N, Tsue C, Kishi K. Labial Adhesions Causing Recurrent Urinary-Tract Infections in an Elderly Woman. Case Rep Med. 2019;2019:7584983. doi: 10.1155/2019/7584983. PubMed PMID: 31929804; PubMed Central PMCID: PMCPMC6942760.
- Singh P, Han HC. Labial adhesions in postmenopausal women: presentation and management. Int Urogynecol J. 2019;30:1429-32. doi: 10.1007/s00192-018-3821-1. PubMed PMID: 30488271.
- Mikos T, Lioupis M, Grimbizis GF. Postmenopausal complete labial fusion and pseudo-incontinence: A case series. Case Rep Womens Health. 2019;21:e00101. doi: 10.1016/j.crwh.2019.e00101. PubMed PMID: 30906695; PubMed Central PMCID: PMCPMC6411508.
- Mohapatra I, Samantaray SR. Labial Fusion Recurrence in a Prepubertal Girl: A Case Report and Review of Literature. Cureus. 2022;14:e26059. doi: 10.7759/cureus.26059. PubMed PMID: 35865425; PubMed Central PMCID: PMCPMC9289966.
- Williams C, Robinson J, Leggio S. Potential effects of postmenopausal labial agglutination on the urinary system. Urol Case Rep. 2021;36:101565. doi: 10.1016/j.eucr.2021.101565. PubMed PMID: 33489771; PubMed Central PMCID: PMCPMC7807131.
- Kwon H. Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report. World J Clin Cases. 2022;10:12990-5. doi: 10.12998/wjcc.v10.i35.12990. PubMed PMID: 36569009; PubMed Central PMCID: PMCPMC9782939.
- Kotoku R, Orita Y. Complete labial fusion with urinary incontinence in a postmenopausal woman: A case report. Case Rep Womens Health. 2022;36:e00465. doi: 10.1016/j.crwh.2022.e00465. PubMed PMID: 36406176; PubMed Central PMCID: PMCPMC9667198.
- Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535. doi: 10.1136/bmj.b2535. PubMed PMID: 19622551; PubMed Central PMCID: PMCPMC2714657.
- Savona-Ventura C. Labial adhesions in postmenopausal women with hip joint disease. Aust N Z J Obstet Gynaecol. 1985;25:303-4. doi: 10.1111/j.1479-828x.1985.tb00752.x. PubMed PMID: 3869456.
- Imamura R, Fujimoto M, Meguro N, Maeda O, Saiki S, Kinouchi T, et al. [Labial adhesion presenting as urinary incontinence and dysuria in a postmenopausal woman: a case report]. Hinyokika Kiyo. 1998;44:843-5. PubMed PMID: 9893235.
- Saito M, Ishida G, Watanabe N, Abe B. Micturitional disturbances due to labial adhesion. Urol Int. 1998;61:50-1. doi: 10.1159/000030286. PubMed PMID: 9792985.
- Ong NC, Dwyer PL. Labial fusion causing voiding difficulty and urinary incontinence. Aust N Z J Obstet Gynaecol. 1999;39:391-3. doi: 10.1111/j.1479-828x.1999.tb03429.x. PubMed PMID: 10554966.
- Yano K, Hosokawa K, Takagi S, Nakai K, Kubo T. Y-V advancement flaps for labial adhesions in postmenopausal women. Plast Reconstr Surg. 2002;109:2614-5. doi: 10.1097/00006534-200206000-00097. PubMed PMID: 12045624.
- Hatada Y. Two-step surgical approach to labial adhesions in a postmenopausal woman. Acta Obstet Gynecol Scand. 2003;82:1054-5. doi: 10.1034/j.1600-0412.2003.00028.x. PubMed PMID: 14616281.
- Julia J, Yacoub M, Levy G. Labial fusion causing urinary incontinence in a postmenopausal female: a case report. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:360-1. doi: 10.1007/s00192-003-1067-y. PubMed PMID: 14618318.
- Migita A, Miyamoto J. Labial Adhesion in Postmenopausal Women: A Report of Two Cases. Nishinihon Journal of Urology. 2005;67:728.
- Pulvino JQ, Flynn MK, Buchsbaum GM. Urinary incontinence secondary to severe labial agglutination. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19:253-6. doi: 10.1007/s00192-007-0415-8. PubMed PMID: 17594045.
- Dirim A, Hasirci E. Labial fusion causing urinary incontinence and recurrent urinary tract infection in a postmenopausal female: a case report. Int Urogynecol J. 2011;22:119-20. doi: 10.1007/s00192-010-1205-2. PubMed PMID: 20571766.
- Fakheri T, Saeidiborojeni H, Jalilian N. Urinary Retention Due to Labial Fusion: Bloodless Correction. A Case Report. The Professional Medical Journal. 2011;18:328-30. doi: 10.29309/TPMJ/2011.18.02.2104.
- Chang CH, Fan YH, Tong-Long Lin A, Chen KK. Bladder outlet obstruction due to labial agglutination. J Chin Med Assoc. 2012;75:40-2. doi: 10.1016/j.jcma.2011.10.006. PubMed PMID: 22240536.
- Lazarou G, Maldonado MQ, Mitchell K. Complete labial fusion with vaginal constriction band presenting as incomplete voiding. Female Pelvic Med Reconstr Surg. 2013;19:181-3. doi: 10.1097/SPV.0b013e3182817c00. PubMed PMID: 23611939.
- James R, Sammarco A, Sheyn D, Mahajan S. Severe labial agglutination release in a postmenopausal woman. Open Journal of Obstetrics and Gynecology. 2014;4:822. doi: 10.4236/ojog.2014.414114.
- Kaplan F, Alvarez J, Dwyer P. Nonsurgical separation of complete labial fusion using a Hegar dilator in postmenopausal women. Int Urogynecol J. 2015;26:297-8. doi: 10.1007/s00192-014-2535-2. PubMed PMID: 25369765.
- Basaranoglu S, Dogan F, Deregozu A. Acute renal failure due to complete labial fusion: A case report. Int J Surg Case Rep. 2016;29:162-4. doi: 10.1016/j.ijscr.2016.08.016. PubMed PMID: 27865142; PubMed Central PMCID: PMCPMC5120264.
- Lu BJ, Chin HY, Chu CY, Wang JTJ. Postmenopausal labial agglutination mimics urinary incontinence and hidden vaginal lesion. J Obstet Gynaecol Res. 2018;44:801-5. doi: 10.1111/jog.13556. PubMed PMID: 29297962.
- Kumagai Y, Toyoshima M, Kudo K, Ohsawa M, Niikura H, Yaegashi N. Endoscopic examination of labial fusion in a postmenopausal woman: a case report. J Med Case Rep. 2018;12:26. doi: 10.1186/s13256-018-1568-4. PubMed PMID: 29391072; PubMed Central PMCID: PMCPMC5796510.
- Takimoto M, Sato T, Ichioka S. Reconstruction for labial adhesion in postmenopausal woman using vulvoperineal flap. Case Reports Plast Surg Hand Surg. 2019;6:136-9. doi: 10.1080/23320885.2019.1602474. PubMed PMID: 32002461; PubMed Central PMCID: PMCPMC6968580.
- Kukreja B, Chandra S, Gyn PAJO. Labial Adhesions in a Post-menopausal Woman. Pan. 2019;2:1-3.
- Laih CY, Huang CP, Chou EC. Labial adhesion in a postmenopausal female: A case report. Medicine (Baltimore). 2020;99:e20803. doi: 10.1097/MD.0000000000020803. PubMed PMID: 32590764; PubMed Central PMCID: PMCPMC7329012.
- Tanvir T, Meeta M, Singh A. Complete Labial Fusion Causing Pseudo-Urinary Incontinence: A Long-Term Sequelae of Genitourinary Syndrome. J Midlife Health. 2020;11:257-9. doi: 10.4103/jmh.JMH_34_20. PubMed PMID: 33767568; PubMed Central PMCID: PMCPMC7978044.
- Murugesan A, Palaniappan Y, Kalaimani T. An Unusual Cause of Urinary Pseudoincontinence: Two Rare Cases of Labial Fusion in Adolescent and Postmenopausal Women. Journal of South Asian Federation of Obstetrics and Gynaecology. 2021;12:196-8. doi: 10.5005/jp-journals-10006-1789.
- Gungor Ugurlucan F, Yasa C, Tas IS, Aslay I, Yalcin O. Complete labial fusion causing urinary retention in a postmenopausal woman. Am J Clin Exp Urol. 2021;9:413-5. PubMed PMID: 34796258; PubMed Central PMCID: PMCPMC8595084.
- Bi Y, Chen Y, Li W, Jiang H, Qin J, Cheng J. Experience with successful treatment of severe recurrent vulvar adhesions: A case report. Front Surg. 2023;10:1052133. doi: 10.3389/fsurg.2023.1052133. PubMed PMID: 36843991; PubMed Central PMCID: PMCPMC9944125.
- Chuong CJ, Hodgkinson CP. Labial adhesions presenting as urinary incontinence in postmenopausal women. Obstet Gynecol. 1984;64:81S-4S. doi: 10.1097/00006250-198409001-00020. PubMed PMID: 6540850.
- Kalantar E. Minimizing potential resistance among bacteria causing urinary tract infection. J Nephropathol. 2012;1:11-2. doi: 10.5812/jnp.3. PubMed PMID: 24475380; PubMed Central PMCID: PMCPMC3886163.
- Ghorbani M, Arabzad SM, Bahrami M. Implementing Shannon entropy, SWOT and mathematical programming for supplier selection and order allocation. International Journal of Supply Chain Management. 2012;1:43-7.
|