Postpartum Labial Adhesion Presenting with Apareunia: A Case Report

Authors

  • AO Ashimi
  • GC Michael

DOI:

https://doi.org/10.30442/ahr.0701-10-119

Keywords:

Apareunia, Labial adhesion, Postpartum, Vaginal birth

Abstract

Labial adhesion is commonly seen in the paediatric and post-menopausal age groups and treatment of this condition with oestrogen cream is effective. On the other hand, postpartum labial adhesion is an unusual complication of vaginal birth except when it associated with trauma to the perineum. In that situation, treatment with oestrogen cream is usually in-effective.

A 19-year-old primipara presented 15 months after vaginal birth with difficulty in having sexual intercourse. She had sustained a perineal tear during her last childbirth at home. Pelvic examination revealed fusion of the medial aspect of the labia minora with a membrane inferior to the external urethral opening completely closing the vaginal orifice. A surgical division under anaesthesia was carried out and she resumed sexual intercourse within five days.

Postpartum labial adhesion is an uncommon complication of vaginal births and surgical division of labial adhesions is the first line of management. Good postpartum perineal care for perineal laceration following vaginal births should be encouraged to prevent apareunia. 

References

Yildirim D, Talmac M. Acquired labial adhesion in a reproductive-aged woman secondary to Systemic Lupus Erythematosus. Pak J Med Sci 2018; 34: 505–507. https://doi.org/10.12669/pjms.342.14364

Aminu MB, Dattijo LM. Labial Fusion following episiotomy in a woman of reproductive age. Orient J Med 2017; 29: 67–70.

Herieka E, Dhar J. Labial adhesions following severe primary genital herpes. Sex Tran Infect2001; 77. https://doi.org/10.1136%2Fsti.77.1.75

Bradford J, Fischer G. Surgical division of labial adhesions in vulvar lichen sclerosus and lichen planus. J Low Genit Tract Dis 2013; 17: 48–50. https://doi.org/10.1097/LGT.0b013e31824f1427

National Population Commission (NPC) [Nigeria] and ICF International. 2019. Nigeria Demographic and Health Survey 2018. Abuja, Nigeria, and Rockville, Maryland, USA: NPC and ICF International.

Seehusen DA, Earwood JS. Postpartum labial adhesions. J Am Board Fam Med 2007; 20: 408–410. http://doi.org/10.3122/jabfm.2007.04.060214

Shaver D, Ling F, Muram D. Labial adhesions in a postpartum patient. Obstet Gynecol. 1986; 68: 24S-25S.

Ashimi AO, Amole TG. Prevalence, reasons and predictors for home births among pregnant women attending antenatal care in Birnin Kudu, North-west Nigeria. Sex Reprod Healthc 2015; 6: 119–125. https://doi.org/10.1016/j.srhc.2015.01.004

Tumbal P, Majumdar R. Postmenopausal complete labial fusion: a rare case study. Int J Reprod Contracept Obstet Gynecol 2016; 5: 1646–8. https://doi.org/10.18203/2320-1770.ijrcog20161343

Wedge E, Ekmark AN, Stenstrom P. Treatment with oestrogen or manual separation for labial adhesion - initial outcome and long term follow up. BMC Pediatr 2018; 18: 104. https://doi.org/10.1186/s12887-018-1018-x

Published

2021-03-03

Issue

Section

Case Report