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Labiolysis, Corrective Surgery for Iatrogenic Labium Minus Fusion

Ostrzenski, Adam MD, PhD

doi: 10.1097/SAP.0000000000001920
Reconstructive Surgery
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Background In this study, corrective labium minus iatrogenic fusion was termed labiolysis. This procedure is a new surgical concept for the therapy of iatrogenic, symptomatic labium minus fusion by revising scar and releasing the labium minus from iatrogenic unnatural fusion with the labium majus and intralabial crease. This study presents a new surgical technique and a review of the pertinent literature on labial fusion and its therapy. In addition, this investigation identified labial fusion risk factors associated with esthetic labioreduction of the labia minora and the likelihood of prevention of this surgical complication. The objectives were to (a) describe step-by-step labiolysis surgical intervention, (b) ascertain surgical outcomes of labiolysis, (c) authenticate specific symptom(s) associated with iatrogenic labium minus fusion and how these symptoms affect the quality of life, (d) assess the labiolysis' ability to relief symptoms of labium minus iatrogenic fusion, and (e) present a specific postoperative care.

Methods A prospective cohort study with a control group was conducted. The study group consists of 7 subjects associated with iatrogenic, symptomatic labium minus fusion and the control group, which also consists of 7 women who were subjected to fenestration labioreduction of the labia minora. The follow-up was conducted for 3 years in both groups. All subjects, from both groups, consented in writing their participation in the study. Validated instruments were used before and after labiolysis to evaluate the outcomes.

Results There are no data in the medical literature describing a conservative medical or surgical treatment for iatrogenic, symptomatic labium minus fusion. In both groups, surgeries were performed under local anesthesia. In either group, no reoperation was performed, and no major or minor complications were observed. All preoperative symptoms associated with iatrogenic labial fusion were cured by labiolysis. Anatomical deformities were either corrected or classified as a satisfactory anatomical outcome. In both groups, the postoperative course was uneventful with full ambulation on the first postoperative day, driving a car on the third day, and returning back to work within 1 week.

Conclusions Labiolysis is a simple surgical operation with a short learning curve, which relieves symptoms, improves quality of life associated with iatrogenic labium minus fusion, and provides an esthetically pleasing surgical outcome. In this study group, no minor and no major surgical complications were observed, and no reoperation was performed.

From the Institute of Gynecology Inc, St. Petersburg, FL.

Received October 26, 2018, and accepted for publication, after revision February 1, 2019.

Conflict of interest and sources of funding: The author declares no conflict of interest.

Reprints: Adam Ostrzenski, MD, PhD, Department of Gynecology, Howard University, Washington, DC. E-mail: ao@baymedical.com.

Online date: June 20, 2019

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