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Pamela Stratton - One of the best experts on this subject based on the ideXlab platform.
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Early Diagnosis of Labial Fusion in Women After Allogeneic Hematopoietic Cell Transplant Enables Outpatient Treatment.
Journal of lower genital tract disease, 2017Co-Authors: Claire Scrivani, Melissa A. Merideth, Tajana Klepac Pulanic, Steven Z. Pavletic, Richard Childs, Matthew M. Hsieh, Pamela StrattonAbstract:Objective The aim of the study was to describe the presentation and successful treatment of Labial Fusion in women after allogeneic hematopoietic cell transplantation (HCT). Materials and methods During routine posttransplant gynecologic evaluation, Labial Fusion was identified in 5 female patients. Clinical data were collected regarding underlying disease, transplant regimen, genital symptoms, systemic sites of chronic graft-versus-host disease (cGvHD) and treatment, and follow-up. Results At presentation, women had a median age of 40 years (range = 35-50) and were 23-month to 8-year post-HCT. Four of the 5 patients with Labial Fusion had evidence of active cGvHD; 3 patients had severe sclerotic cGvHD, and 1 patient had bronchiolitis obliterans. One had rheumatoid arthritis and had recently stopped taking etanercept, but had no sites of cGvHD. One patient presented with only a pinpoint opening for passage of urine. Her complete Labial Fusion was lysed under general anesthesia. Three of the 4 others presented with dyspareunia. Their labia were fused between the clitoris and urethra narrowing the vaginal opening without obstructing the urethra. These Labial adhesions were successfully lysed during an office procedure. Once the Labial mucosa healed, the patients applied topical clobetasol and estrogen to prevent reagglutination. On follow-up, 1 month to 1 year later, all women were significantly improved. Conclusions These patients highlight the importance of asking women who have undergone allogeneic HCT, especially those with severe cGvHD, about dyspareunia and dysuria. Those with genital symptoms warrant referral to a gynecologist. These cases illustrate that Labial Fusion, if diagnosed early enough, may be treated successfully with an office procedure and medical therapy.
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Labial Fusion: a rare complication of chronic graft-versus-host disease.
Obstetrics and gynecology, 2008Co-Authors: John M Norian, Pamela StrattonAbstract:Hematopoetic stem cell transplantation may be complicated by genital graft-versus-host (GVH) disease and may uncommonly result in Labial Fusion. A 22-year-old woman with a history of Ewing's sarcoma and acute myelogenous leukemia received chemotherapy and total-body irradiation followed by a matched, unrelated donor hematopoetic stem cell transplantation. After transplantation, she developed chronic GVH disease involving the skin, eyes, mouth, and joints. Concomitant vulvar pruritus was presumed to be a fungal infection but, in fact, was genital GVH disease manifesting as Labial Fusion. Topical estrogen, topical steroids, and surgical division of the labia were successful. Genital GVH disease should be considered in women with genital tract complaints after hematopoetic stem cell transplantation. Labial Fusion secondary to chronic GVH disease may be treated successfully with surgery and medical therapy.
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Labial Fusion: a rare complication of chronic graft-versus-host disease.
Obstetrics & Gynecology, 2008Co-Authors: John M Norian, Pamela StrattonAbstract:Allogeneic hematopoietic stem cell transplant is a treatment that is increasingly being used for a variety of malignant and nonmalignant diseases of the bone marrow and immune system. However, it may be complicated by chronic graft-versus-host (GVH) disease in 30% to 50% of transplants from human leukocyte antigens-matched siblings and 60% to 70% from matched unrelated donors.1,2 Acute VGH disease is prevented by immunosuppression. Frequently chronic GVH disease has an insidious onset over several weeks or months, varies from mild to severe disease, and is managed with immunosuppressive agents. The skin, mouth, eyes, liver, and intestines are the organs most commonly involved in chronic GVH disease. Compared with those receiving bone marrow transplant (BMT), patients receiving peripheral blood stem cell transplantation may have a more protracted course that more commonly involves the skin, vagina, and vulva.1 When the genital tract is affected in chronic GVH disease, this can add significant morbidity to patient's lives. Spinelli and colleagues3 demonstrated genital tract involvement in nearly 25% of patients with GVH disease, with the majority having vulvar disease manifested as erosions and fissures and a smaller proportion developing vaginal scarring, which often necessitated surgical treatment.3,4 Vulvar scarring is less commonly reported with chronic GVH disease and may result in Labial Fusion. Hypoestrogenism from chemotherapy-induced premature ovarian failure and chronic GVH disease can both cause vulvar or vaginal pain and irritation, which are distinguished by the appearance of the mucosa, which is pale in hypoestrogenism and reddened in chronic GVH disease. Here we describe a patient who developed Labial Fusion in the setting of hypoestrogenism and vulvar chronic GVH disease after receiving a peripheral blood stem cell transplantation.
Ayhan Dirim - One of the best experts on this subject based on the ideXlab platform.
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Labial Fusion causing urinary incontinence: reply by the author
International Urogynecology Journal, 2011Co-Authors: Ayhan DirimAbstract:Dear Editor, Actually, stress urinary incontinence was the complaint of the patient on admission. The clinical picture, however, was overflow incontinence. That is why we did not mention any correction of stress incontinence; we just treated the overflow incontinence by relieving the obstruction [1]. It is clear that overflow incontinence may be described by a patient as stress incontinence, so a detailed history and diagnostic approach is mandatory.
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Labial Fusion causing urinary incontinence and recurrent urinary tract infection in a postmenopausal female: a case report
International Urogynecology Journal, 2011Co-Authors: Ayhan Dirim, Eray HasirciAbstract:A 73-year-old postmenopausal woman was admitted with recurrent urinary tract infection and a history of incontinence. General physical examination was normal. Complete Labial Fusion was noticed on genital examination. Surgical intervention was performed. This therapy alleviated incontinence and recurrent urinary tract infection.
John M Norian - One of the best experts on this subject based on the ideXlab platform.
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Labial Fusion: a rare complication of chronic graft-versus-host disease.
Obstetrics and gynecology, 2008Co-Authors: John M Norian, Pamela StrattonAbstract:Hematopoetic stem cell transplantation may be complicated by genital graft-versus-host (GVH) disease and may uncommonly result in Labial Fusion. A 22-year-old woman with a history of Ewing's sarcoma and acute myelogenous leukemia received chemotherapy and total-body irradiation followed by a matched, unrelated donor hematopoetic stem cell transplantation. After transplantation, she developed chronic GVH disease involving the skin, eyes, mouth, and joints. Concomitant vulvar pruritus was presumed to be a fungal infection but, in fact, was genital GVH disease manifesting as Labial Fusion. Topical estrogen, topical steroids, and surgical division of the labia were successful. Genital GVH disease should be considered in women with genital tract complaints after hematopoetic stem cell transplantation. Labial Fusion secondary to chronic GVH disease may be treated successfully with surgery and medical therapy.
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Labial Fusion: a rare complication of chronic graft-versus-host disease.
Obstetrics & Gynecology, 2008Co-Authors: John M Norian, Pamela StrattonAbstract:Allogeneic hematopoietic stem cell transplant is a treatment that is increasingly being used for a variety of malignant and nonmalignant diseases of the bone marrow and immune system. However, it may be complicated by chronic graft-versus-host (GVH) disease in 30% to 50% of transplants from human leukocyte antigens-matched siblings and 60% to 70% from matched unrelated donors.1,2 Acute VGH disease is prevented by immunosuppression. Frequently chronic GVH disease has an insidious onset over several weeks or months, varies from mild to severe disease, and is managed with immunosuppressive agents. The skin, mouth, eyes, liver, and intestines are the organs most commonly involved in chronic GVH disease. Compared with those receiving bone marrow transplant (BMT), patients receiving peripheral blood stem cell transplantation may have a more protracted course that more commonly involves the skin, vagina, and vulva.1 When the genital tract is affected in chronic GVH disease, this can add significant morbidity to patient's lives. Spinelli and colleagues3 demonstrated genital tract involvement in nearly 25% of patients with GVH disease, with the majority having vulvar disease manifested as erosions and fissures and a smaller proportion developing vaginal scarring, which often necessitated surgical treatment.3,4 Vulvar scarring is less commonly reported with chronic GVH disease and may result in Labial Fusion. Hypoestrogenism from chemotherapy-induced premature ovarian failure and chronic GVH disease can both cause vulvar or vaginal pain and irritation, which are distinguished by the appearance of the mucosa, which is pale in hypoestrogenism and reddened in chronic GVH disease. Here we describe a patient who developed Labial Fusion in the setting of hypoestrogenism and vulvar chronic GVH disease after receiving a peripheral blood stem cell transplantation.
Eray Hasirci - One of the best experts on this subject based on the ideXlab platform.
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Labial Fusion causing urinary incontinence and recurrent urinary tract infection in a postmenopausal female: a case report
International Urogynecology Journal, 2011Co-Authors: Ayhan Dirim, Eray HasirciAbstract:A 73-year-old postmenopausal woman was admitted with recurrent urinary tract infection and a history of incontinence. General physical examination was normal. Complete Labial Fusion was noticed on genital examination. Surgical intervention was performed. This therapy alleviated incontinence and recurrent urinary tract infection.
W. L. M. Robson - One of the best experts on this subject based on the ideXlab platform.
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Labial Fusion and asymptomatic bacteriuria
European Journal of Pediatrics, 1993Co-Authors: A. K. C. Leung, W. L. M. RobsonAbstract:Thirty-three female children with Labial Fusion were screened for bacteriuria which was defined as the growth of a single micro-organism with ≥100 000 colony-forming units/ml (≥ 100×10^6 colonies/l) in a properly collected urine specimen. Six girls were found to have bacteriuria. In contrast, none of the 33 girls in a control group had bacteriuria. We recommend that a urine culture be performed in girls with Labial Fusion and that all girls with bacteriuria should be checked for Labial Fusion.
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The incidence of Labial Fusion in children
Journal of paediatrics and child health, 1993Co-Authors: A. K. C. Leung, W. L. M. Robson, J. Tay-uybocoAbstract:A retrospective study of 9070 female infants born at the Foothills Provincial Hospital was conducted to determine the incidence of Labial Fusion at birth. A prospective study was also conducted on 1970 female patients assessed through a paediatric outpatient clinic to determine the incidence of Labial Fusion in this population. None of the newborn infants had Labial Fusion. Thirty-five children (1.8%) assessed at the paediatric outpatient clinic were found to have Labial Fusion with a peak incidence at 13-23 months of age (3.3%)
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Labial Fusion and urinary tract infection.
Child nephrology and urology, 1992Co-Authors: A. K. C. Leung, W. L. M. RobsonAbstract:: We report 9 female patients with Labial Fusion and concomitant urinary tract infection. The mean age at presentation was 47 months. All except 1 patient had Labial Fusion extending at least 50% of the length of the labia minora. All had symptoms of urinary tract infection and a positive urine culture. We recommend that a urine culture be performed in children with Labial Fusion and that all girls with urinary tract infection should be checked for Labial Fusion.
