Pulvino James Q, Flynn Michael K, Buchsbaum Gunhilde M
Department of Obstetrics and Gynecology, University of Rochester, Rochester, NY, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Feb;19(2):253-6. doi: 10.1007/s00192-007-0415-8. Epub 2007 Jun 27.
The purpose of the study was to describe the presentation and management of urinary incontinence because of severe labial adhesions. Records of all patients diagnosed with labial agglutination and urinary incontinence at the Division of Gynecologic Specialties between January 1999 and February 2006 were reviewed. Clinical presentation, management, and treatment outcome were extracted from the records. Five subjects were identified. Mean age was 78 (range 59-87) years. Four subjects presented with mixed and one with urge urinary incontinence. Four reported change in flow of stream with voiding. Physical examination showed near-total occlusion of the introitus and urethral meatus in four subjects and partial occlusion in one subject. All were treated topically with estrogen and/or steroids. None of the subjects improved with conservative management, and all required lysis of the labial adhesions. Postoperatively, all were treated with daily topical estrogen and three with concurrent topical steroids. All subjects reported resolution of voiding dysfunction; three had complete resolution of their incontinence. Lysis of labial adhesions combined with postoperative topical estrogen and steroids appears to be an effective treatment in women with this condition.
本研究的目的是描述因严重阴唇粘连导致的尿失禁的临床表现及治疗方法。回顾了1999年1月至2006年2月期间在妇科专科诊断为阴唇粘连和尿失禁的所有患者的记录。从记录中提取临床表现、治疗方法及治疗结果。共确定了5名患者。平均年龄为78岁（范围59 - 87岁）。4名患者表现为混合性尿失禁，1名患者表现为急迫性尿失禁。4名患者报告排尿时尿流改变。体格检查显示4名患者阴道口和尿道口几乎完全闭塞，1名患者部分闭塞。所有患者均接受局部雌激素和/或类固醇治疗。所有患者经保守治疗均无改善，均需进行阴唇粘连松解术。术后，所有患者均接受每日局部雌激素治疗，3名患者同时接受局部类固醇治疗。所有患者均报告排尿功能障碍得到解决；3名患者尿失禁完全缓解。阴唇粘连松解术联合术后局部雌激素和类固醇治疗似乎是治疗这种情况的女性的有效方法。
