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Labial Fusion

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1. Endoscopic examination of labial fusion in a postmenopausal woman: a case report Full Text available with Trip Pro

Endoscopic examination of labial fusion in a postmenopausal woman: a case report Labial fusion is defined as adhesions of the labia minora or majora. Labial fusion may cause urinary retention. Surgical treatment based on an accurate anatomic assessment may be needed, but the usefulness of endoscopic examination for this disease has not been reported.A 76-year-old Japanese woman undergoing chemoradiation treatment for esophageal cancer was referred to our department for evaluation of high (...) accumulation in the vagina on a positron emission tomography scan. On physical examination, her labia were noted to be extensively fused with a pinhole opening at the midline. Endoscopic examination revealed that her vagina was filled with urine and there were no abnormalities in her urethral meatus and cervix. The adhesions were separated under anesthesia and there has been no recurrence during follow-up.We present a case of a postmenopausal patient with labial fusion who underwent successful surgical

2018 Journal of medical case reports

2. Labial Fusion

Labial Fusion Labial Fusion Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Labial Fusion Labial Fusion Aka: Labial Fusion , Labia (...) Minora Fusion II. Definition Labial Fusion Labia minora fuses in prepubescent girls, blocking the vaginal introitus III. Pathophysiology Low level irritation of the labia minora Hypoestrogenized labial tissue IV. Signs Labia minora fused, blocking the vaginal introitus Patient still able to urinate despite fusion V. Management Avoid manually separating the fused labia (painful, and typically refuses) Practice good hygiene with daily baths and frequent diaper changes Apply daily, a small amount

2019 FP Notebook

3. Labial fusion: A rare cause of urinary retention in reproductive age woman and review of literature Full Text available with Trip Pro

Labial fusion: A rare cause of urinary retention in reproductive age woman and review of literature Labial fusion usually affects prepubertal girls and postmenopausal women, it may rarely occurs in reproductive years in the absence of predisposing factors such as vulvar infections, dermatitis, trauma, female circumcision and lichen sclerosis. Should be considered in differential diagnosis in the differential diagnosis of urinary retention even if the patient doesn't have history of sexual

2017 Turkish journal of urology

4. Early Diagnosis of Labial Fusion in Women after Allogeneic Hematopoietic Cell Transplant Enables Outpatient Treatment Full Text available with Trip Pro

. Her complete labial fusion was lysed under general anesthesia. Three of the 4 others presented with dyspareunia. Their labia were fused between the clitoris and urethra narrowing the vaginal opening without obstructing the urethra. These labial adhesions were successfully lysed during an office procedure. Once the labial mucosa healed, the patients applied topical clobetasol and estrogen to prevent reagglutination. On follow-up, 1 month to 1 year later, all women were significantly improved.These (...) Early Diagnosis of Labial Fusion in Women after Allogeneic Hematopoietic Cell Transplant Enables Outpatient Treatment The aim of the study was to describe the presentation and successful treatment of labial fusion in women after allogeneic hematopoietic cell transplantation (HCT).During routine posttransplant gynecologic evaluation, labial fusion was identified in 5 female patients. Clinical data were collected regarding underlying disease, transplant regimen, genital symptoms, systemic sites

2017 Journal of lower genital tract disease

5. Acute renal failure due to complete labial fusion: A case report Full Text available with Trip Pro

Acute renal failure due to complete labial fusion: A case report Acute renal failure is characterized by rapidly disruption in kidney function and postrenal causes typically result from obstruction of urinary flow. Multiple etiologies were described for acute renal failure, but labial fusion in postmenopausal female is a quite rarely encountered pathology among postrenal causes. Only a few cases have been presented in postmenopausal women presenting with urinary retention. We present a case (...) with acute renal failure due to complete labial fusion in a postmenopausal woman and its treatment.Copyright © 2016. Published by Elsevier Ltd.

2016 International journal of surgery case reports

6. Do hygienic factors affect labial fusion recurrence? A search for possible related etiologic factors. (Abstract)

Do hygienic factors affect labial fusion recurrence? A search for possible related etiologic factors. The purpose of our study was to define the factors related to recurrence of labial fusion.The data of 110 patients diagnosed with labial fusion were gathered. The data collected and queried included age and body weight of the patient, season of presentation/occurrence, frequency of diaper change, frequency of diaper dermatitis, products used for hygiene, duration of breast milk feeding (...) , infections, presence of allergy, thickness of the adhesion, mother's use of oral contraceptive drugs before pregnancy, mother's use of alcohol/drugs/cigarettes or presence of disease during pregnancy, the number of recurrences, treatment method, presence of labial fusion among maternal sisters or any relatives, and blood estrogen levels.Eighty-one patients (73.6%) with labial fusion were admitted for the first time, whereas 29 patients (26.4%) had been treated previously at least once. The adhesion

2012 Journal of Pediatric Surgery

7. Treatment of Prepubertal Labial Adhesions

of labial adhesions in prepubertal girls. Generally, for medical treatment of labial adhesions, topical estrogen is applied to the adhesion whist applying gentle lateral traction to promote separation of the labia. It is, therefore, plausible that the lateral traction applied to the adhesion site is what ultimately results in the separation of the labial fusion, while the use of estrogen improves healing after mechanical separation. This is a single site, prospective, randomized, double-blinded study (...) provided by Tazim Dowlut-McElroy, Children's Mercy Hospital Kansas City: Vulvar disease, adhesions, topical therapy Labial adhesions prepubertal girls Labial agglutination Labial fusion Additional relevant MeSH terms: Layout table for MeSH terms Tissue Adhesions Cicatrix Fibrosis Pathologic Processes Estradiol Polyestradiol phosphate Estradiol 3-benzoate Estradiol 17 beta-cypionate Estrogens Hormones Hormones, Hormone Substitutes, and Hormone Antagonists Physiological Effects of Drugs Contraceptive

2014 Clinical Trials

8. Labial Adhesions (Overview)

: Dec 13, 2018 Author: Kenneth G Nepple, MD; Chief Editor: Andrea L Zuckerman, MD Share Email Print Feedback Close Sections Sections Labial Adhesions Overview Practice Essentials Labial adhesions (also referred to as labial agglutination) are a common disorder in prepubertal females. They are a fusion of labia minora in the midline, are usually asymptomatic, and typically can be treated conservatively. Labial adhesions must be differentiated from other pediatric vaginal or urethral disorders (eg (...) is necessitated by symptoms or parental requests such as frequent UTIs, topical estrogen cream is indicated If medical care does not result in separation of the labia minora or if urinary retention or UTIs are present, manual or surgical separation may be considered Avoiding exposure to possible irritants (eg, strong detergents, bubble baths, harsh soaps) may be beneficial Referral to a pediatric urologist or gynecologist may be appropriate if the provider is uncomfortable with treating labial adhesions

2014 eMedicine Pediatrics

9. Labial Adhesions (Treatment)

by symptoms or blockage of most of the vaginal opening, topical estrogen cream is indicated. If medical care does not result in separation of the labia minora or if labial adhesions are severe and associated with urinary retention, manual or surgical separation may be considered. Other reasons to consider intervention include severe fibrous dense adhesions or rare cases with urinary retention. (See the images below.) Labial adhesions before lysis. Labial adhesions after lysis. Because labial adhesions may (...) or estradiol vaginal cream 0.01%) directly onto the area of adhesions of the labia minora. [ , ] The cream can be applied to the adhesions two or three times daily for several weeks. Once the adhesions start to separate, the application frequency can be decreased and application of an emollient added. A literature review performed in 2007 reported that the success rate of topical estrogen intervention in girls with labial adhesions is typically about 90%, with published success in case series reports

2014 eMedicine Pediatrics

10. Labial Adhesions (Follow-up)

by symptoms or blockage of most of the vaginal opening, topical estrogen cream is indicated. If medical care does not result in separation of the labia minora or if labial adhesions are severe and associated with urinary retention, manual or surgical separation may be considered. Other reasons to consider intervention include severe fibrous dense adhesions or rare cases with urinary retention. (See the images below.) Labial adhesions before lysis. Labial adhesions after lysis. Because labial adhesions may (...) or estradiol vaginal cream 0.01%) directly onto the area of adhesions of the labia minora. [ , ] The cream can be applied to the adhesions two or three times daily for several weeks. Once the adhesions start to separate, the application frequency can be decreased and application of an emollient added. A literature review performed in 2007 reported that the success rate of topical estrogen intervention in girls with labial adhesions is typically about 90%, with published success in case series reports

2014 eMedicine Pediatrics

11. Labial Adhesions (Diagnosis)

Updated: Dec 13, 2018 Author: Kenneth G Nepple, MD; Chief Editor: Andrea L Zuckerman, MD Share Email Print Feedback Close Sections Sections Labial Adhesions Overview Practice Essentials Labial adhesions (also referred to as labial agglutination) are a common disorder in prepubertal females. They are a fusion of labia minora in the midline, are usually asymptomatic, and typically can be treated conservatively. Labial adhesions must be differentiated from other pediatric vaginal or urethral disorders (...) : If treatment is necessitated by symptoms or parental requests such as frequent UTIs, topical estrogen cream is indicated If medical care does not result in separation of the labia minora or if urinary retention or UTIs are present, manual or surgical separation may be considered Avoiding exposure to possible irritants (eg, strong detergents, bubble baths, harsh soaps) may be beneficial Referral to a pediatric urologist or gynecologist may be appropriate if the provider is uncomfortable with treating labial

2014 eMedicine Pediatrics

12. Diagnosis and Management of Hymenal Variants

,suchaswithatransversevaginalseptumandaresulting hematometra. The perineum is best examined in either the dorsal lithotomy or frog-legged position. When examining the patient, downward labial traction can open and separate the labia majora and minora sufficiently to visualize the distal introitus. A moist cotton or nasopharyngeal swab is useful to assess whether the hymen is perforate. The swab can be placed through a perforation and then gently tented to the introitus to confirm the diagnosis (Fig. 2). If the swab cannot be passed behind (...) .) VOL. 133, NO. 6, JUNE 2019 Committee Opinion Hymenal Variants e3753. Joki-ErkkilaMM,HeinonenPK.Presentingandlong-term clinical implications and fecundity in females with ob- structing vaginal malformations. J Pediatr Adolesc Gyne- col 2003;16:307–12. 4. Schober J, Dulabon L, Martin-Alguacil N, Kow L, Pfaff D. Significance of topical estrogens to labial fusion and vag- inal introital integrity. J Pediatr Adolesc Gynecol 2006;19: 337–9. 5. Ossman AME, El-Masry YI, El-Namoury MM, Sarsik SM

2019 American College of Obstetricians and Gynecologists

13. Management of Acute Obstructive Uterovaginal Anomalies

with amenorrhea, dysmenorrhea, pelvic pain, recurrent vaginal discharge, or infertility. The evaluation of a patient with a suspected obstructive reproductive anomaly should include a detailed medical history, physical examination, and imaging. The genital examination is critical to differentiate a patient with an imperforate hymen from a patient with labial adhesions, urogenital sinus, transverse vaginal septum, or distal vaginal atresia. Pelvic ultrasonography is the initial imaging method recommended (...) anomalies. Obstetrician– gynecologists should be aware of obstructive conditions that result from a failure of the müllerian ducts to fuse. Incomplete vertical fusion of the caudal müllerian duct with the sinovaginal bulbs leads to cervical atresia, transverse vaginal septa, or distal vaginal atresia. Incomplete resorption ofuterineorvaginalsepta leadsto rudimentary and obstructed uterine horns or obstructive hemivagina and ipsilateral renal anomaly (also referred to as OHVIRA or Herlyn-Werner

2019 American College of Obstetricians and Gynecologists

15. Lichen Sclerosus

often see an erythema next to depigmented spots (either hyperkeratotic or sclerotic) and fissures. Purpura or ecchymoses are typical and harmless but for some patients distressing features of LS. The Köbner phenomenon that describes the development of lesions in previously normal skin after scratching or other trauma is well recognized.(Wallace 1971) Scarring is common and is observed in about 80% of women and 30% of girls with LS.(Cooper 2004) It may lead to loss and agglutination of the labia (...) minora possibly midline fusion with loss of the clitoral hood and narrowing of the vaginal introitus. Perianal involvement is typical in females, rarely seen in males, showing erythema, skin atrophy or sclerosis with erosions and fissures, or rarely scarring possibly leading to anal stenosis. Women commonly report itching, burning pain, painful or less pleasurable sexual intercourse, and anal or genital bleeding due to fissuring of the damaged tissue. Painful defecation may be a problem (fissures

2018 European Dermatology Forum

17. Gynecologic Issues in Children and Adolescent Cancer Patients and Survivors

, or compromised fertility (6). Stem Cell Transplant Graft-versus-host disease is a manifestation of hemato- poietic allogenic stem cell transplantation with a high prevalence of 11–48% (13). Vaginal symptoms include pain, itching, burning, dyspareunia, labial fusion, vaginal synechiae, and stenosis. Early identification is the key to preventing long-term sequelae such as vaginal stenosis andhematocolpos;however,thereisfrequentlyadelayto diagnosis. A careful examination by a gynecologist is encouraged

2018 American College of Obstetricians and Gynecologists

18. British Association of Dermatologists' guidelines for the management of lichen sclerosus

of key future research recommendations (FRRs) FRR1 What is the role of topical calcineurin inhibitors in treating people with LS? FRR2 What is the role of topical steroids in preventing malig- nancy in genital LS in female patients? FRR3 What is the course of LS after puberty in female patients? FRR4 What is the optimal surgical management of female patients with fusion over the clitoris? FRR5 Would acitretin in combination with a topical steroid be more effective than monotherapy in treating people (...) symptoms and urinary incontinence are reported by women with LS, 44,45 but have been shown to be less common than inthe general population inanother study. 45,46 The typical lesions are porcelain-white papules and plaques, often associated with areas of ecchymosis. Follicular delling may be prominent, and occasionally hyperkeratosis is a promi- nent feature. The characteristic sites are the interlabial sulci, labia minora, clitoral hood, clitoris and perineal body. LS is a scarring dermatosis and may

2018 British Association of Dermatologists

19. BSR guideline Management of Adults with Primary Sjögren's Syndrome Full Text available with Trip Pro

dryness (Schirmer’s test ⩽5 mm in 5 min or van Bijsterveld score ⩾4), objective oral dryness (unstimulated salivary flow rate ⩽0.1 ml/min or positive salivary scintigraphy and sialography), positive anti-Ro/La antibodies, labial gland focus score ⩾1 including at least one of the last two objective features. The 2016 ACR–EULAR classification criteria are based on the weighted sum of five items and require a total score ⩾4 to meet the criteria for diagnosis where the presence of anti-Ro antibodies (...) , depend on the classification criteria used, referral bias and access to labial gland biopsy. Need for guideline pSS typically presents in women in their fifth or sixth decade, although up to 10% of cases occur in men and it is also seen in younger people. Studies using the AECG criteria have estimated the prevalence in women in the UK at 0.1–0.4% [ ]. Patients present to primary care physicians, general physicians, ophthalmologists and dental practitioners many of whom lack specialist knowledge

2017 British Society for Rheumatology

20. Newborn Nursing Care Pathway

bilaterally Central urethral opening Foreskin not retractable Epithelial pearls may be present on penile shaft Smegma may be found on foreskin Erections common Parent education/ Anticipatory Guidance • Refer to >12 – 24 hr Variance • Undifferentiated • Female Fusion of labia • Male Urethral opening below/above tip of penis (hypospadius) Unequal scrotal size Testes palpable in inguinal canal or not palpable Hydrocele Intervention • Nursing Assessment • Refer to PCHP prn Norm and Normal Variations (...) mother’s/ family/supports understanding of newborn physiology and capacity to identify variances that may require further assessments Refer to: • elimination Norm and Normal Variations • Anus patent • Females Labia swollen Labia majora to midline Urethral open behind clitoris – in front of vaginal opening Clitoris maybe enlarged Hymenal tag is normally present Vernix caseosa present between labia Whitish mucoid or pseudomensus • Males Scrotum swollen – rugae present Testes descended palpable

2015 British Columbia Perinatal Health Program

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