Premium
Vulval Varicosities and Labial Reduction
Author(s) -
Fliegner John R.H.
Publication year - 1997
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1997.tb02237.x
Subject(s) - labia minora , labia , medicine , surgery , vulva , general surgery , plastic surgery
EDITORIAL COMMENT: We accepted this paper for publication since we agree with the author that it is rare for patients to request surgery for enlargement of the labia minora. Presumably patients would take such a problem to a gynaecologist, although as reference 3 shows, the editor would refer the unusual problem of vulval varicosities requiring surgery to a vascular surgeon, although the case concerned was complicated in other ways. Variation in size of the labia minora is quite remarkable as is the rarity of women seeking surgical correction of the condition. The editor has managed only one such patient, a woman with asymmetrical enlargement of the labia minora. Against his better judgement a simple reduction was performed on the left labium minus. Postoperatively the patient complained of intolerable pain although the wound appeared uncomplicated and healed uneventfully. The woman when last seen at follow‐up 3 months later remained unhappy with the operation and was concerned by the apparent enlargement of the right labium minus. Perhaps we should ask our plastic surgeon colleagues if they often perform plastic surgery for enlargement or asymmetry of the labia minora. Our senior gynaecologist reviewer stated that he has performed ligation of vulval varicosities in nonpregnant women in the way described by the author. He also stressed the need to mark the varicosities with the patient in the standing position prior to surgery. We reviewed the gynaecological surgical audit of one Melbourne hospital for 6 years to determine the prevalence of labial reduction. There were 3,896 cases of major abdominal or vaginal surgery, 2,126 laparoscopics and 14,054 of minor surgery, including 6 of labia minora reduction by excision of the excessive tissue; the operation was unilateral in 5 women and bilateral in 1. Summary: Vulval varicosities and hypertrophic labia minora are 2 conditions that receive relatively little attention in the literature. However, they may cause especially bothersome discomfort in some women. Appropriate surgical treatment is eminently successful if certain guidelines and attention to detail are followed. The treatment of both conditions is described based on illustrative case reports, and a review made of the surgical anatomy.