Hakan PEKER, Onur GÜNALDI, Berna HALİLOĞLU PEKER

Postmenapozal Dönemde Komplet Labial Füzyona Bağlı Akut Üriner Retansiyon Olgusu: Bir Olgu Sunumu ve Literatür Araştırması

Kliniğimizin acil servisine ani başlayan idrar yapamama ve kasık ağrısı şikayeti ile 74 yaşında bir hastabaşvurdu. Hastanın genel fizik muayenesi normaldi ancak yapılan dış genital sistem muayenesindekomplet labial füzyon tespit edildi. Labial füzyon, labium minusların birbirine tam ya da kısmi olarakyapışması olarak tanımlanan bir durumdur ve genellikle prepubertal dönemde görülmektedir.Postmenapozal dönemde ise çok nadir olarak gelişmektedir. Genel anestezi altında acil olarak cerrahiişlem uygulanan hastanın operasyon sonrası şikayetleri kayboldu. Komplet labial füzyon, kadınhayatının hangi döneminde olursa olsun genellikle, idrar tutamama ve idrarını boşaltma fonksiyonundabozukluk bulguları ile kendini gösterir. Literatür araştırmamız ve kendi olgumuz göstermektedir ki;postmenapozal dönemde ortaya çıkan labial füzyon prepubertal dönemin aksine, genellikle medikaltedaviye dirençlidir. Böyle olgulara cerrahi işlem uygulandığında dramatik bir şekilde iyileşmeolmaktadır.

Acute Urinary Retention Due to Complete Labial Fusion in the Postmenopausal Period: A Case Report and Literature Review

A 74‐year‐old patient was admitted to the emergency department of our clinic with sudden onset of urination and groin pain. The patient's general physical examination was normal, but a complete labial fusion was detected in the external genital system examination. Labial fusion is defined as the complete or partial adherence of labium minus to each other and is usually seen in the prepubertal period. It is very rare in the postmenopausal period. The patient underwent emergency surgery under general anesthesia and his complaints disappeared after the operation. Complete labial fusion, usually in the period of women's life, is manifested by the findings of dysfunction of the urinary incontinence and urination function. Our literature research and our own case show that; The labial fusion that occurs in the postmenopausal period is usually resistant to medical treatment, unlike the prepubertal period. In such cases, a dramatic improvement is achieved when surgery is performed.

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1. Chang CH, Fan YH, Tong‐Long Lin A, Chen KK. Bladder outlet obstruction due to labial agglutination. J Chin Med Assoc. 2012;75(1):40–2.
2. Roy Kallol Kumar, Agarwal Sonika, Chanana Charu, Kumar Sunesh, Malhotra Neena. Labial adhesions in pubertal girls. Archives of Gynecology and Obstetrics 2006;273(4):243–5
3. Kaplan F, Alvarez J, Dwyer P. Nonsurgical separation of complete labial fusion using a Hegar dilator in postmenopausal women. Int Urogynecol J Pelvic Floor Dysfunct. 2015;26(2):297–8.
4. Julia J, Yacoub M, Levy G. Labial fusion causing urinary incontinence in a postmenopausal female: a case report. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:360–1.
5. Palla L, De Angelis B, Lucarini L, Spallone D, Palla G. Cervelli V. a case of labial fusion and urinary pseudo‐incontinence in an elderly woman. A surgical treatment and a review. Eur Rev Med Pharmacol Sci. 2010;14(5):491–3.
6. Awang NA, Viegas C, Viegas OA. Incomplete bladder emptying due to labial fusion in a pubertal girl: a delayed consequence of female circumcision. Aust N Z J Obstet Gynaecol 2004;44:371‐3
7. Rebecca James, Anne Sammarco, David Sheyn, Sangeeta Mahajan. Severe Labial Agglutination Release in a Postmenopausal Woman. Open Journal of Obstetrics and Gynecology, 2014;4:822‐5
8. Chuong, C.J. and Hodgkinson, P. Labial Adhesions Presenting as Urinary Incontinence in Postmenopausal Women. Obstetrics Gynecology. 1984;64:81‐84. http://dx.doi.org/10.1097/00006250‐198409001‐00020
9. S. Başaranoğlu, F. Dogan, A. Deregözü. Acute renal failure due to complete labial fusion: A case report. International Journal of Surgery Case Reports. 2016;29:162–4
10. S.Erkanlı, E.Şimşek, B.Haydardedeoğlu, A.Parlakgümüş, E.Kuşçu. Premenapozal 40 yaşında hastada gelişen labial füzyon. Turk J Obstet Gynecol 2006;3(5):359‐61