Abstract
Introduction
Labia minora adhesions (LMA) are a common finding in young girls. Usually, this condition
is asymptomatic and spontaneously disappears during adolescence. We report on a case
revealed by infected urocolpos and peritonitis and whose treatment finally required
surgical reduction labioplasty.
Case report
A 9-year-old girl presented with a 2-day history of abdominal pain and fever. Urinary
continence had never been obtained, with diurnal leaks. Physical examination showed
signs of peritoneal irritation and a subtotal vulvar obstruction due to LMA. At surgery,
after LMA lysis, a large amount of cloudy urine-like fluid emptied under pressure
from the vagina. Laparoscopy showed generalized peritonitis without any intraabdominal
cause. The same Escherichia coli was identified in the infected urocolpos and the abdominal fluid. Postoperative course
was uneventful.
Because of recurrent LMA, the patient underwent several courses of local estrogen
therapy. Labia minora hypertrophy with LMA developed 2 years after peritonitis, requiring
surgical reduction labioplasty. We used a new technique with interposition of skin
flaps. The girl is now well, without LMA or infection, 4 years after labioplasty.
Conclusion
Although rare, subtotal vulvar obstruction because of LMA may lead to infected hydrocolpos
and peritonitis. Recurrent LMA may necessitate surgical labioplasty.
Key words
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Article info
Publication history
Accepted:
April 26,
2008
Received in revised form:
March 29,
2008
Received:
December 6,
2007
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
