Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 16, 2022; 10(35): 12990-12995
Published online Dec 16, 2022. doi: 10.12998/wjcc.v10.i35.12990
Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report
Hyejin Kwon
Hyejin Kwon, Department of Obstetrics and Gynecology, Won Kwang University Sanbon Hospital, Won Kwang University School of Medicine, Gunpo-si, 15865, Gyeonggi-do, South Korea
Author contributions: Kwon H contributed to manuscript writing, editing, data collection, and analysis and has read and approved the final manuscript.
Informed consent statement: The patient provided written consent for the publication of this case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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Corresponding author: Hyejin Kwon, MD, Adjunct Associate Professor, Department of Obstetrics and Gynecology, Won Kwang University Sanbon Hospital, Won Kwang University School of Medicine, 321, Sanbon-ro, Gunpo-si, 15865, Gyeonggi-do, South Korea. jennylv0319@wku.ac.kr
Received: June 6, 2022
Peer-review started: June 6, 2022
First decision: August 4, 2022
Revised: August 8, 2022
Accepted: November 28, 2022
Article in press: November 28, 2022
Published online: December 16, 2022
Processing time: 187 Days and 4.7 Hours
Abstract
BACKGROUND

Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report

CASE SUMMARY

The case of an 83-year-old woman who presented with dysuria, urination disorders, recurrent cystitis, and bacteriuria and was admitted to a private hospital after 1 mo of antibiotic treatment without improvement of her symptoms. Upon examination, labial adhesions were observed with nearly-complete labial fusion with a pinpoint opening. Bacteriuria was detected in urine analysis, and the urine culture test was positive for Escherichia coli. Therefore, a parenteral antibiotic (Fosfomycin) and topical estrogen cream were administered. However, since the adhesion did not separate after 2 wk of treatment, surgical correction was performed. First, adhesiolysis was conducted with a blunt instrument. Then, hysteroscopy and cystoscopy were performed. Hysteroscopic findings showed no abnormalities of the endometrium and endocervix, and the cystoscopic results were also normal. Finally, labiaplasty was completed to prevent adhesion recurrence. One month after the surgery, the discomfort while urinating was eliminated and the adhesion did not recur.

CONCLUSION

Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams, and surgical treatment should be considered.

Keywords: Post menopause; Genitalia, female; Cystitis; Gynecologic Surgical Procedures; Atrophy; Urinary Retention; Case report

Core Tip: Labial adhesions have a prevalence of approximately 1.8% in infants aged 13-23 mo, however, but they are rarely found in adult women, especially in women of reproductive age. Few cases have been reported in postmenopausal women. Labial adhesion is caused by various inflammatory diseases and estrogen deficiency. The beginning of adhesion occurs most frequently around the clitoris, and depending on the extent of the adhesion, it is classified as complete or partial type. Our case represents a therapeutic example of complete labial adhesion with a pinpoint-sized opening in a postmenopausal woman.