title: Nonsurgical separation of complete labial fusion using a Hegar dilator in postmenopausal women.
abstract: OBJECTIVE
  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.
authors.affiliation: Mercy Hospital for Women, Heidelberg, Australia, franciscokaplan@gmail.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Kaplan
authors.forename: Julio
authors.initials: J
authors.lastname: Alvarez
authors.forename: Peter
authors.initials: P
authors.lastname: Dwyer
mesh_terms: D000368:Aged; D004106:Dilatation / Q000295:instrumentation*; D004210:Dissection / Q000295:instrumentation*; D005260:Female; D006801:Humans; D017698:Postmenopause; D014549:Urinary Incontinence / Q000209:etiology; D014845:Vulvar Diseases / Q000150:complications / Q000628:therapy*