Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report

BACKGROUND: Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report CASE SUMMARY: The case of an 83-year-old woman who presented with dysuria, urination disorders, recurrent cystitis, and bacteriuria and was admitted to a private hospital after 1 mo of antibiotic treatment without improvement of her symptoms. Upon examination, labial adhesions were observed with nearly-complete labial fusion with a pinpoint opening. Bacteriuria was detected in urine analysis, and the urine culture test was positive for Escherichia coli. Therefore, a parenteral antibiotic (Fosfomycin) and topical estrogen cream were administered. However, since the adhesion did not separate after 2 wk of treatment, surgical correction was performed. First, adhesiolysis was conducted with a blunt instrument. Then, hysteroscopy and cystoscopy were performed. Hysteroscopic findings showed no abnormalities of the endometrium and endocervix, and the cystoscopic results were also normal. Finally, labiaplasty was completed to prevent adhesion recurrence. One month after the surgery, the discomfort while urinating was eliminated and the adhesion did not recur. CONCLUSION: Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams, and surgical treatment should be considered.