Surgical correction of labial posterior commissure Deformities: A Follow-Up study on alleviating superficial dyspareunia.

BACKGROUND

Labial posterior commissure deformities are a significant yet underrecognized cause of superficial dyspareunia, substantially impacting women's quality of life. Despite their clinical relevance, classification and surgical management strategies remain insufficiently studied.

METHODS

We analyzed 31 patients with labial posterior commissure deformities, categorized into a post-inflammatory abnormality group (n = 10) and an anatomical abnormality group (n = 21). Flap-based surgical correction was performed in both groups: a vaginal mucosal advancement flap for the post-inflammatory group and a modified Fenton procedure with an advancement flap for the anatomical group. Postoperative outcomes were assessed using the Visual Analog Scale (VAS) for sexual pain, healing time, and patient satisfaction.

RESULTS

Two patients were lost to follow-up. The average healing time was 3.78 weeks for post-inflammatory group and 2.35 weeks for anatomical group. Preoperative VAS scores were higher in the post-inflammatory group (7.59 ± 1.13) compared to the anatomical group (5.40 ± 0.88, p < 0.001). Surgical significantly reduced pain in both groups (post-inflammatory: 4.22 ± 1.09, p < 0.001; anatomical: 3.70 ± 0.87, p < 0.001), with no significant difference in pain reduction between them. Patient satisfaction was higher in the anatomical group (95.0 %) than the post-inflammatory group (77.8 %).

CONCLUSION

Flap-based surgical correction effectively alleviates superficial dyspareunia caused by labial posterior commissure deformities, addressing both functional and aesthetic concerns. The selection of surgical technique based on the underlying etiology ensures optimal outcomes. These findings highlight the importance of individualized treatment strategies in improving patient comfort and satisfaction.