Abstract and Introduction
Background: Labial adhesions are common in young girls and menopausal women. Topical estrogen is the first line of therapy for these adhesions. Based on a systematic literature review, postpartum labial adhesions are uncommon in clinical practice. They are not painful but can prevent patients from resuming normal sexual activity. Topical estrogen therapy is an ineffective treatment option for adhesions in this setting. Surgical division under local anesthesia is usually effective.
Case: A 29-year-old women presented at 6 weeks after an uncomplicated vacuum-assisted delivery for a routine postpartum evaluation. Examination revealed a 5-mm labial adhesion connecting her left and right labia minora. Division under local anesthetic resulted in a complete recovery within 3 days.
Conclusion: Postpartum labial adhesions can usually be surgically divided under local anesthetic with complete and rapid recovery.
Labial adhesions are common in young girls and occasionally occur in elderly women. It is hypothesized that the relative hypoestrogenic states of these age groups predispose them to labial adhesions. Although surgical dissection is sometimes required, topical estrogen creams and gentle massage usually lead to successful breakdown of adhesions in these groups within a few weeks. Labial adhesions have also been described in reproductive age women secondary to female circumcision, lichen sclerosis, herpes simplex, diabetes, pemphigoid, and caustic vaginitis.[3,4,5,6,7] Postpartum labial adhesions are rarely described in the medical literature.
J Am Board Fam Med. 2007;20(4):408-410. © 2007 American Board of Family Medicine
Cite this: Postpartum Labial Adhesions - Medscape - Jul 01, 2007.