1/3. Case report: labial fusion postpartum and clinical management of labial lacerations.lacerations of the external genitalia of various degrees are a common occurrence in the childbirth process. Evidence-based management of minor lacerations of the vulva has yet to emerge in the scientific literature. Spontaneous approximation of minor lacerations of the labia may uncommonly result in distorted anatomical healing, with resultant dyspareunia, among other distressing symptoms. Management of this occurrence, including pharmacologic and surgical strategies, is presented in this case study discussion.- - - - - - - - - - ranking = 1keywords = labial (Clic here for more details about this article) |
2/3. A new surgical technique to treat refractory labial fusion in the elderly.An elderly woman with refractory labial fusion was treated by labial separation. The subsequent raw area was covered by a rotational skin flap from the thigh. The flap was deroofed of epithelium proximally and tunnelled subcutaneously. The distal portion emerged to cover the raw clitoral area and this successfully prevented contraction and scarring.- - - - - - - - - - ranking = 0.75keywords = labial (Clic here for more details about this article) |
3/3. sjogren's syndrome in women presenting with chronic dyspareunia.OBJECTIVE: To identify cases of sjogren's syndrome among women with chronic dyspareunia who did not already have a diagnosed rheumatological disorder. DESIGN: Prospective recruitment over 12 months. SETTING: Tertiary referral service for the assessment of vulval disease. PARTICIPANTS: women with chronic dyspareunia who had musculoskeletal symptoms, Raynaud's phenomenon or symptoms of ocular or oral dryness. methods: The women underwent a Schirmer tear test and a comprehensive auto-antibody screen including latex fixation test for rheumatoid factor, antinuclear, anti-Ro, anti-La and anti-salivary duct antibodies. A labial salivary gland biopsy and vaginal biopsy were taken for routine histological analysis. MAIN OUTCOME MEASURES: Cases of definite and probable sjogren's syndrome were identified using the European criteria. RESULTS: Eleven women were assessed for features of sjogren's syndrome. Four had definite primary Sjogren's syndrome, two had probable primary sjogren's syndrome and one had probable secondary sjogren's syndrome. Among these seven women the median duration of vaginal symptoms was seven years (range 0.25-20), of ocular symptoms was one year (range 0.25-2) and of oral symptoms was 1.5 years (range 0-6). In all but one woman dyspareunia presented before ocular or oral symptoms, often by many years. CONCLUSIONS: Although well-recognised as a feature of established sjogren's syndrome, this study emphasises that chronic dyspareunia can be a presenting feature in these women, antedating the emergence of ocular or oral symptoms by many years. Symptoms of ocular or oral dryness, Raynaud's phenomenon or musculoskeletal symptoms should be sought in women with chronic dyspareunia to identify those who merit further investigation.- - - - - - - - - - ranking = 0.125keywords = labial (Clic here for more details about this article) |