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Nephrogenic Adenoma in the Setting of Refractory Labial Agglutination in an Elderly Woman

Bretschneider, Carol Emi, MD, MST*; Share, Sarah M., MD; Paraiso, Marie Fidela R., MD*

Female Pelvic Medicine & Reconstructive Surgery: July/August 2018 - Volume 24 - Issue 4 - p e6–e8
doi: 10.1097/SPV.0000000000000553
Case Reports

Background Severe labial agglutination can be refractory to outpatient management and can lead to voiding dysfunction in postmenopausal women. Labial agglutination is often a sequela of long-standing inflammatory processes, which include untreated lichen planus, lichen sclerosus, and atrophic vaginitis.

Case An 82-year-old parous woman presented with severe labial agglutination and complete obstruction of her vaginal introitus, causing obstructive voiding symptoms. She underwent a surgical procedure to release the fused labia. Pathologic evaluation of a vulvar biopsy revealed nephrogenic adenoma, which is an uncommon benign lesion usually presenting in the urinary tract.

Conclusions Refractory, severe labial agglutination in postmenopausal women can lead to significant voiding dysfunction, and the underlying chronic inflammation may result in pathologic changes such as nephrogenic adenoma. Pathologic tissue diagnosis is important to plan appropriate surveillance for patients with this chronic condition.

Refractory, severe labial agglutination in postmenopausal women can lead to significant voiding dysfunction, and the underlying chronic inflammation may result in pathologic changes such as nephrogenic adenoma.

From the *Section of Urogynecology and Reconstructive Pelvic Surgery, Obstetrics, Gynecology & Women's Health Institute, Cleveland Clinic; and

Robert J Tomsich Pathology and Laboratory Medicine Institute, Department of Pathology, Cleveland Clinic, Cleveland, OH.

Correspondence: Carol Emi Bretschneider, MD, Cleveland Clinic, 9500 Euclid Ave, Desk A81, Cleveland, OH 44195. E-mail: emibrets@gmail.com.

Disclosures: None.

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