Nonsurgical separation of complete labial fusion using a Hegar dilator in postmenopausal women.

INTRODUCTION AND HYPOTHESIS: Labial fusion is a rare condition in postmenopausal women. The cause is unknown but is associated with low estrogen levels and chronic vulval inflammation. The aim of this video is to demonstrate the nonsurgical separation of labia using blunt dissection with a Hegar dilator in postmenopausal women with complete labia fusion.

METHODS

Two postmenopausal women with urinary incontinence and voiding difficulty secondary to complete fusion of labia minora failed estrogen treatment and underwent labial separation using serial Hegar dilators to restore normal introital anatomy. Medical treatment with estrogen and digital massage was administered after surgery to avoid recurrence.

RESULTS

Nonsurgical separation of labia is appropriate in postmenopausal women with complete labia minora fusion when medical treatment fails.