Preventing Recurrent Labial, Clitoral Adhesions

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Preventing Recurrent Labial, Clitoral Adhesions

Kate , Contributing Writer

[skin & Allergy News 30(8):27, 1999. © 1999 International Medical News

Group.]

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NEW ORLEANS -- Surgicel, an oxidized regenerated cellulose gauze,

helped prevent recurrent adhesions in three girls following surgery

for labial and clitoral hood adhesions.

Surgicel " has been used internally to decrease adhesions in the

peritoneal cavity, but it has not been reported externally before, "

said Dr. Lesley Breech, who presented her findings in poster form at

the annual meeting of the North American Society for Pediatric and

Adolescent Gynecology.

" Usually when you do this surgery, the two labia get swollen and

adhere, and these two raw edges reagglutinate, causing a high

recurrence rate, " said study coauthor Dr. Marc Laufer, chief of

pediatric and adolescent gynecology at Brigham and Women's Hospital,

Boston.

" But by having a barrier between them, they remain separated long

enough for the swelling to go down, which gives them a chance to

epithelialize. "

The investigators presented three cases of severe recurrent labial and

clitoral hood adhesions in two 14-year-olds and one 15-year-old.

" They had all had previous treatments ranging from hormonal creams to

surgery, including electrocautery. But in all of them the adhesions

kept recurring, causing so much pain that they couldn't even walk, "

explained Dr. Breech of the division of pediatric/adolescent

gynecology at Washington University School of Medicine, St. Louis.

Labial adhesions can cause pain, retention of urine, pooling of

menstrual blood, and problems with tampon placement. Clitoral

adhesions can cause painful clitoral entrapment and pooling of

secretions.

" In one case, there were so many secretions and the clitoris was so

adhesed that when we incised it, we removed a several-centimeter mass

of secretions that had been pressing on the clitoris, causing a great

deal of pain, " she said.

In all cases, labial and clitoral hood adhesions were separated

surgically, and a barrier of Surgicel was sutured in place and allowed

to dissolve over 48 hours.

All patients have been followed for over a year with no recurrence of

adhesions, she said.