WordNet

a fibrous band of scar tissue that binds together normally separate anatomical structures
abnormal union of bodily tissues; most common in the abdomen
relating to or near the female labium
of or relating to the lips of the mouth; "labial stops"

PrepTutorEJDIC

粘着,付着
くちびる(lip)の / 唇音(しんおん)の / 唇音([m][p][b]など)
labiumの複数形

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/10/13 18:52:33」(JST)

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Labial fusion is a medical condition of the female genital anatomy where the labia minora become fused together. It is generally a pediatric condition.^[1]

The condition is known by a number of names, including labial fusion, labial adhesion, labial synechiae, labial agglutination, labial adherence, gynatresia, vulvar fusion, and vulvar synechiae.^[2]

Presentation

Labial fusion is never present at birth, but rather acquired later in infancy, since it is caused by insufficient estrogen exposure and newborns have been exposed to maternal estrogen in utero. It typically presents in infants at least 3 months old.^[3] Most presentations are asymptomatic and are discovered by a parent or during routine medical examination. In other cases, patients may present with associated symptoms of dysuria, urinary frequency, refusal to urinate, or post-void dribbling.^[2]^[4] Some patients present with vaginal discharge due to pooling of urine in the vulval vestibule or vagina.^[5]

Diagnosis

The condition can be diagnosed based on inspection of the vulva. In patients with labial fusion, a flat plane of tissue with a dense central line of tissue is usually seen when the labia majora are retracted, while an anterior opening is usually present below the clitoris.^[2]

Pathophysiology

The primary contributing factor to labial fusion is low estrogen levels.^[3] A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly.^[2]^[3]

Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.^[4]

Treatment

Treatment is not usually necessary in asymptomatic cases, since most fusions will separate naturally over time, but may be required when symptoms are present.^[6]^[7] The standard method of treatment for labial fusion is the application of topical estrogen cream onto the areas of adhesion, which is effective in 90% of patients.^[2] In severe cases where the labia minora are entirely fused, causing urinary outflow obstruction or vaginal obstruction, the labia should be separated surgically.^[3] Recurrence after treatment is common^[8] but is thought to be prevented by good hygiene practices.^[4] One study has shown that betamethasone may be more effective than estrogen cream in preventing recurrence, with fewer side effects.^[9]

Complications

Labial fusion can lead to urinary tract infection, vulvar vestibulitis and inflammation caused by chronic urine exposure. In severe cases, labial adhesions can cause complete obstruction of the urethra, leading to anuria and urinary retention.^[3]

Epidemiology

Labial fusion is not uncommon in infants and young girls.^[1] It is most common in infants between the ages of 13 and 23 months, and has an incidence of 3.3% in this age group.^[3] It is estimated that labial fusion occurs in 1.8% of all prepubertal girls.^[3] It is rare in adult women, particularly in reproductive age, but is occasionally found in postpartum and postmenopausal women.^[3]

References

^ ^a ^b "NHS Direct Wales - Encyclopedia: Labial fusion". NHS Direct Wales. Retrieved 2011-09-13.
^ ^a ^b ^c ^d ^e Fleisher, Gary R.; Ludwig, Stephen (2010). Textbook of Pediatric Emergency Medicine. Lippincott Williams & Wilkins. p. 842. ISBN 9781605471594.
^ ^a ^b ^c ^d ^e ^f ^g ^h Broecker, Jane E. D. (2008). "Imperforate hymen". The 5-minute Obstetrics and Gynecology Consult. Lippincott Williams & Wilkins. pp. 122–123. ISBN 9780781769426.
^ ^a ^b ^c Zitelli, Basil J.; McIntire, Sara C.; Nowalk, Andrew J. (2012). Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. Elsevier. p. 580. ISBN 9780323091589.
^ Smith, Roger Perry (2008). Netter's Obstetrics and Gynecology. Elsevier. p. 202. ISBN 9781416056829.
^ Belman, A. Barry; King, Lowell R.; Kramer, Stephen A. (2001). Clinical Pediatric Urology. CRC Press. pp. 219–220. ISBN 9781901865639.
^ Creighton, Sarah (2005). "Paediatric and adolescent gynaecology". Paediatric Surgery (2nd ed.). CRC Press. pp. 555–556. ISBN 9780340809105.
^ Baskin, Laurence; Swana, Hubert S. (2008). "Genitourinary Tumors". Clinical Problems in Pediatric Urology. John Wiley & Sons. pp. 175–176. ISBN 9781405171854.
^ Mayoglou, Lazarus; Dulabon, Lori; Martin-Alguacil, Nieves; Pfaff, Donald; Schober, Justine (August 2009). "Success of Treatment Modalities for Labial Fusion: A Retrospective Evaluation of Topical and Surgical Treatments". Journal of Pediatric and Adolescent Gynecology 22 (4): 247–250. doi:10.1016/j.jpag.2008.09.003.

External links

Labial adhesions at Medscape

UpToDate Contents

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1. 思春期前の小児における外陰膣に関する愁訴 vulvovaginal complaints in the prepubertal child
2. 新生児および小児の婦人科検査 gynecologic examination of the newborn and child
3. 小児および思春期における排尿困難の評価 evaluation of dysuria in children and adolescents
4. 小児における身体的診察：会陰 the pediatric physical examination the perineum
5. 外陰部硬化性苔癬 vulvar lichen sclerosus

English Journal

Increased expression of cell adhesion molecule receptors on monocyte subsets in ischaemic heart failure.

Wrigley BJ, Shantsila E, Tapp LD, Lip GY.SourceProf. Gregory Y. H. Lip, University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, B18 7QH, UK, Tel.: +44 507 5080, Fax: +44 554 4083, E-mail: g.y.h.lip@bham.ac.uk.
Thrombosis and haemostasis.Thromb Haemost.2013 Jun 6;110(1). [Epub ahead of print]
The objective of this study was to evaluate the expression of cell adhesion molecule (CAM) receptors (integrins) on monocyte subsets in heart failure (HF) and examine their prognostic implication.Increased levels of soluble CAMs have been observed in patients with HF, but the precise mechanism of mo
PMID 23740177

Comparative study of Pluronic(®) F127-modified liposomes and chitosan-modified liposomes for mucus penetration and oral absorption of cyclosporine A in rats.

Chen D, Xia D, Li X, Zhu Q, Yu H, Zhu C, Gan Y.SourceShanghai Institute of Materia Medica, Chinese Academy of Sciences, No. 501, Haike Road, Zhang Jiang Hi-Tech Park, Pudong, Shanghai 201203, China.
International journal of pharmaceutics.Int J Pharm.2013 Jun 5;449(1-2):1-9. doi: 10.1016/j.ijpharm.2013.04.002. Epub 2013 Apr 11.
Liposomes modified using cationic and hydrophilic nonionic polymers are 2 popular carriers for improving oral drug absorption. Cationic polymer-modified liposomes can adhere to the intestinal wall mucus (mucoadhesive type), while liposomes modified using hydrophilic nonionic polymers can penetrate a
PMID 23583840

Japanese Journal

子宮癌・子宮筋腫・陰唇癒着症 (特集過活動膀胱と紛らわしい疾患・病態 : 鑑別診断のポイント) -- (婦人科疾患)

加藤久美子,鈴木省治,鈴木晶貴 [他]
臨床泌尿器科 67(7), 519-524, 2013-06
NAID 40019703486

形成術および術後エストロゲン軟膏塗布が奏効した閉経後陰唇癒着症の1症例

河原直紀,藤本佳克,丸山祥代 [他],山下健
産婦人科の進歩 65(1), 46-50, 2013
陰唇癒着症は後天的に左右の陰唇が正中で癒着する外陰部疾患である．低エストロゲン状態を基礎に，炎症や感染，外傷等が加わることにより発症するとされる．主に乳幼児期に発症し，成人期での発症は比較的まれである．今回，閉経後に発症した排尿障害を伴う陰唇癒着症の1症例を経験したので，若干の文献的考察も加えて報告する．症例は82歳．特記すべき既往歴はないが，高齢のため臥床傾向であった．肉眼的血尿と排尿時痛を主訴 …
NAID 130003362651

「陰唇癒着症」

Labial fusion
Classification and external resources
Specialty	medical genetics
ICD-10	Q52.5
eMedicine	article/953412

　　[★]

英: labial adhesion
関: 陰唇

「adhesion」

　　[★]

n

接着、付着、粘着、粘着力、凝着、密着、溶着、癒着、支持、索状帯。固守、執着

「labial」

　　[★]

adj.

(解剖)唇の、唇状の

[nhsdirectwales-1] "NHS Direct Wales - Encyclopedia: Labial fusion". NHS Direct Wales. Retrieved 2011-09-13.

[fleischer-2] Fleisher, Gary R.; Ludwig, Stephen (2010). Textbook of Pediatric Emergency Medicine. Lippincott Williams & Wilkins. p. 842. ISBN 9781605471594.

[adams-3] ^ ^a ^b ^c ^d ^e ^f ^g ^h Broecker, Jane E. D. (2008). "Imperforate hymen". The 5-minute Obstetrics and Gynecology Consult. Lippincott Williams & Wilkins. pp. 122–123. ISBN 9780781769426.

[zitelli-4] Zitelli, Basil J.; McIntire, Sara C.; Nowalk, Andrew J. (2012). Zitelli and Davis' Atlas of Pediatric Physical Diagnosis. Elsevier. p. 580. ISBN 9780323091589.

[netter-5] Smith, Roger Perry (2008). Netter's Obstetrics and Gynecology. Elsevier. p. 202. ISBN 9781416056829.

[belman-6] Belman, A. Barry; King, Lowell R.; Kramer, Stephen A. (2001). Clinical Pediatric Urology. CRC Press. pp. 219–220. ISBN 9781901865639.

[burge-7] Creighton, Sarah (2005). "Paediatric and adolescent gynaecology". Paediatric Surgery (2nd ed.). CRC Press. pp. 555–556. ISBN 9780340809105.

[8] Baskin, Laurence; Swana, Hubert S. (2008). "Genitourinary Tumors". Clinical Problems in Pediatric Urology. John Wiley & Sons. pp. 175–176. ISBN 9781405171854.

[9] Mayoglou, Lazarus; Dulabon, Lori; Martin-Alguacil, Nieves; Pfaff, Donald; Schober, Justine (August 2009). "Success of Treatment Modalities for Labial Fusion: A Retrospective Evaluation of Topical and Surgical Treatments". Journal of Pediatric and Adolescent Gynecology 22 (4): 247–250. doi:10.1016/j.jpag.2008.09.003.

リンク元	「陰唇癒着症」
関連記事	「adhesion」「labial」

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案内

案内

labial adhesion