Acute urinary retention due to complete labial fusion in the postmenopausal period: A case report and literature review

Year 2019, Volume: 19 Issue: 2, 429 - 433, 28.06.2019

Onur Günaldı Hakan Peker Berna Halıloğlu Peker

https://doi.org/10.17098/amj.577014

Abstract

A 74-year-old patient was admitted to the emergency department of our clinic with sudden onset of urination and groin pain. The patient's general physical examination was normal, but a complete labial fusion was detected in the external genital system examination. Labial fusion is defined as the complete or partial adherence of labium minus to each other and is usually seen in the prepubertal period. It is very rare in the postmenopausal period. The patient underwent emergency surgery under general anesthesia and his complaints disappeared after the operation. Complete labial fusion, usually in the period of women's life, is manifested by the findings of dysfunction of the urinary incontinence and urination function. Our literature research and our own case show that; The labial fusion that occurs in the postmenopausal period is usually resistant to medical treatment, unlike the prepubertal period. In such cases, a dramatic improvement is achieved when surgery is performed.

Keywords

Labial adhesion, labial fusion, vulvar fusion, labia minor agglutination, urinary retention

Postmenapozal dönemde komplet labial füzyona bağlı akut üriner retansiyon olgusu: Bir olgu sunumu ve literatür araştırması

Abstract

Kliniğimizin acil servisine,  ani
başlayan idrar yapamama ve kasık ağrısı şikayeti ile 74 yaşında bir hasta
başvurdu. Hastanın genel fizik muayenesi normaldi ancak yapılan dış genital sistem
muayenesinde komplet labial füzyon tespit edildi. Labial füzyon, labium minusların
birbirine tam ya da kısmi olarak yapışması olarak tanımlanan bir durumdur ve genellikle
prepubertal dönemde görülmektedir. Postmenapozal dönemde ise çok nadir olarak
gelişmektedir. Genel anestezi altında acil olarak cerrahi işlem uygulanan
hastanın operasyon sonrası şikayetleri kayboldu. Komplet labial füzyon, kadın
hayatının hangi döneminde olursa olsun genellikle, idrar tutamama ve idrarını
boşaltma fonksiyonunda bozukluk bulguları ile kendini gösterir. Literatür
araştırmamız ve kendi olgumuz göstermektedir ki; postmenapozal dönemde ortaya
çıkan labial füzyon prepubertal dönemin aksine, genellikle medikal tedaviye
dirençlidir. Böyle olgulara cerrahi işlem uygulandığında dramatik bir şekilde
iyileşme olmaktadır.  

Keywords

Labial adezyon, labial füzyon, vulvar füzyon, labia minör aglütinasyonu, üriner retansiyon

References

• Chang CH, Fan YH, Tong-Long Lin A, Chen KK. Bladder outlet obstruction due to labial agglutination. J Chin Med Assoc. 2012;75(1):40–2.
• Roy Kallol Kumar, Agarwal Sonika, Chanana Charu, Kumar Sunesh, Malhotra Neena. Labial adhesions in pubertal girls. Archives of Gynecology and Obstetrics 2006;273(4):243–5
• Kaplan F, Alvarez J, Dwyer P. Nonsurgical separation of complete labial fusion using a Hegar dilator in postmenopausal women. Int Urogynecol J Pelvic Floor Dysfunct. 2015;26(2):297–8.
• 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.
• Palla L, De Angelis B, Lucarini L, Spallone D, Palla G. Cervelli V. a case of labial fusion and urinary pseudo-incontinence in an elderly woman. A surgical treatment and a review. Eur Rev Med Pharmacol Sci. 2010;14(5):491–3.
• Awang NA, Viegas C, Viegas OA. Incomplete bladder emptying due to labial fusion in a pubertal girl: a delayed consequence of female circumcision. Aust N Z J Obstet Gynaecol 2004;44:371-3
• Rebecca James, Anne Sammarco, David Sheyn, Sangeeta Mahajan. Severe Labial Agglutination Release in a Postmenopausal Woman. Open Journal of Obstetrics and Gynecology, 2014;4:822-5
• Chuong, C.J. and Hodgkinson, P. Labial Adhesions Presenting as Urinary Incontinence in Postmenopausal Women. Obstetrics Gynecology. 1984;64:81-84. http://dx.doi.org/10.1097/00006250-198409001-00020
• S. Başaranoğlu, F. Dogan, A. Deregözü. Acute renal failure due to complete labial fusion: A case report. International Journal of Surgery Case Reports. 2016;29:162–4
• S.Erkanlı, E.Şimşek, B.Haydardedeoğlu, A.Parlakgümüş, E.Kuşçu. Premenapozal 40 yaşında hastada gelişen labial füzyon. Turk J Obstet Gynecol 2006;3(5):359-61