The management of fusion of the labia minora pudendi in adult women using a radiosurgical knife

Abstract

Fusion of the labia minora is a rare event in adult women and rarely seen as a clinical entity. We present a case of a 30-year-old woman with labial fusion, unmarried, a virgin, and sexually inactive with the complaint of discomfort during menstruation and difficulty in micturition since her puberty. The labia minora were fused in the midline with a pinpoint aperture for draining urine, while the clitoris could not be visualized. Previous history regarding a causal factor was perineal trauma in childhood. Effective surgical resection to separate the fusion was done by a radio frequency surgical knife. After the surgical separation, it was possible to expose the normal hymen behind the previously fused labia. We have shown that the separation of labial fusion in adult women with a radio frequency surgical knife, associated with topical application of estrogen cream, prevents re-fusion of the labia and leads to healing without scarring of the vulva.