Gulia Caterina, Zangari Andrea, Briganti Vito, Bateni Zhoobin H, Porrello Alessandro, Piergentili Roberto
Department of Gynecology, Obstetrics and Urology, Policlinico Umberto I, Sapienza, University of Rome, Rome, Italy.
Azienda Ospedaliera San Camillo Forlanini, UOC Pediatric Surgery and Urology, Rome, Italy.
Int Urogynecol J. 2017 Oct;28(10):1453-1461. doi: 10.1007/s00192-016-3253-8. Epub 2017 Jan 18.
We provide a review of the literature about the onset and development of hypertrophy of the labia minora, together with some expert opinions on the appropriateness of labiaplasty.
We searched PubMed and used popular search engines, with a greater emphasis on the physiology and hormone-mediated metabolism of these structures, and less emphasis on their surgical treatment.
We describe major embryological, cytological, and biochemical features of this anatomical part and summarize the clinical aspects of its hypertrophy, evaluating types of discomfort reported by women and the medical treatments available. Also, based on what is known about the artificial elongation and spontaneous hypertrophy of the inner labia, we illustrate and discuss the main biological factors that may trigger this medical condition. There are not enough data identifying a clear inheritance of inner labia hypertrophy in the absence of other pathological conditions; instead, we found indirect evidence for an association with transient episodes of local inflammation either before birth or during puberty. We also analyze the role played by estrogen receptors and other factors with regard to the onset of this condition and highlight the importance of their timing in determining the size of women's labia minora. Remarkably, most cases of enlarged labia minora should be considered as outliers that are within the physiological range of size variation described for these structures.
We generally advise against surgical treatment of labia minora, especially in young, pre-pubertal girls, unless specific medical conditions are also present and/or the psychological impact on the patient is deemed particularly negative.
我们对小阴唇肥大的发病及发展相关文献进行了综述，并就阴唇整形术的适宜性给出了一些专家意见。
我们检索了PubMed并使用了常用搜索引擎，更侧重于这些结构的生理学及激素介导的代谢，而较少关注其手术治疗。
我们描述了这一解剖部位的主要胚胎学、细胞学及生化特征，总结了其肥大的临床情况，评估了女性报告的不适类型及可用的医学治疗方法。此外，基于对内阴唇人工延长和自然肥大的已知情况，我们阐述并讨论了可能引发这种病症的主要生物学因素。在没有其他病理状况的情况下，尚无足够数据确定小阴唇肥大存在明确的遗传现象；相反，我们发现了与出生前或青春期局部炎症短暂发作相关的间接证据。我们还分析了雌激素受体及其他因素在这种病症发病过程中所起的作用，并强调了它们出现的时间在决定女性小阴唇大小方面的重要性。值得注意的是，大多数小阴唇增大的病例应被视为处于这些结构所描述的生理大小变化范围内的异常情况。
我们一般不建议对小阴唇进行手术治疗，尤其是对青春期前的年轻女孩，除非同时存在特定的医学状况和/或对患者的心理影响被认为特别负面。
