Classification of the labia minora
Miranda A. Farage, Howard I. Maibach in The Vulva, 2017
The labia minora, like the lip, are one of several places in the body that have a defined mucocutaneous junction (Figure 34.2). As in lip augmentation or reconstruction, these anatomical landmarks must be preserved. The labia minora are made up of a wet mucosa (analogous to the wet vermillion of the lip), a dry mucosa (analogous to the dry vermillion), and a keratinized, often pigmented epithelium (analogous to the skin bordering the dry vermillion, separated by the white roll). Each of these zones average 1 cm in length, but may vary. The wet mucosa in the posterior vestibule is typically 1.5-times wider than the anterior vestibule. Because of these anatomic similarities, lip vermillion reconstruction using a full-thickness labia minora graft has previously been reported (10).
Vaginal Dysmorphia
Philipa A Brough, Margaret Denman in Introduction to Psychosexual Medicine, 2019
The labia minora play an important role in sexual response and function. At their edges there is dense nerve innervation and the presence of oestrogen receptors. At their base there is erectile tissue which becomes engorged during arousal. There is no good research on sexual function following labiaplasty. There are, however, numerous patient accounts of sexual dysfunction following FGCS. Clearly this needs to be set against the potential bias that patients whose sexual function has improved will not seek medical attention. Reliable research into surgical and sexual outcomes is lacking. Liao concludes that surgery appears to have been offered on demand, justified by verbal reports of physical and psychological difficulties that were not formally evaluated pre- or post-surgery.
Carcinoma of the vagina and vulva
Pat Price, Karol Sikora in Treatment of Cancer, 2014
The mons pubis is a pad of fat anterior to the pubic symphysis and covered by hair-bearing skin. The labia majora extend posteriorly from the mons on either side of the pudendal cleft into which the urethra and vagina open. They merge with one another and the perineal skin anterior to the anus. They consist largely of areolar tissue and fat. On their lateral aspects the skin is pigmented and covered with crisp hairs. On the medial side the skin is smooth and has many sebaceous glands. The labia minora are small folds of skin that lie between the labia majora and divide anteriorly to envelope the clitoris. The clitoris is an erectile structure analogous to the male penis. Partly hidden by the anterior folds of the labia minora, the clitoris consists of a body of two corpora cavernosa lying side-by-side and connected to the pubic and ischial rami, and a glans of sensitive, spongy erectile tissue. The vestibule is that area between the labia minora into which the urethra and vagina open. The bulbs of the vestibule are elongated masses of erectile tissue lying on either side of the vaginal opening.
Assessing symptomatic vulvar, vaginal, and lower urinary tract atrophy
Published in Climacteric, 2019
S. Palacios
The epithelium of the vulvar labia minora, as well as the vulvar dermis, contains estrogen receptors, but fewer than the vagina, and there are very few of them in the keratinized epithelium of the labia majora, where they are only identified in certain basal layer cells1. The abundance of estrogen receptors has been demonstrated in the vaginal wall, especially in the mucosal epithelium – in various cell strata – and to a lesser extent in the fibroblasts of the lamina propria and the stromal smooth muscle4. The presence of the two types of estrogen receptors – α and β – has been documented in the vagina, with α receptors being mostly present in the epithelium, the stroma, and the muscle fibers and β receptors being present in the blood vessel endothelium5. Both the bladder trigone and the urethra of the woman contain numerous estrogen receptors6. In addition, there are also androgen receptors both in the epithelium and the stroma of the human vagina7.
Molecular study and genotype–phenotype in Chinese female patients with 46, XY disorders of sex development
Published in Gynecological Endocrinology, 2021
Junke Xia, Jing Wu, Chen Chen, Zhenhua Zhao, Yanchuan Xie, Zhouxian Bai, Xiangdong Kong
P.5 complained of primary amenorrhea. Testicles were detected around her right iliac fossa by US. The serum testosterone was 11.37 ng/mL. Her mother’s sister suffered from the same symptoms (Supplement Figure 1). P.6 complained of primary amenorrhea. Normal female genitals were observed. US showed no uterus, and two ovarian-like masses around her bilateral iliac vessels. Needle biopsy was performed, and pathology results confirmed that the two masses were actually testicles. P.7 visited the hospital because of genital abnormality. Her clitoridauxe resembled a micropenis, behind which the urinary meatus was observed. The vaginal orifice could not be observed. Labia majora and labia minora were normal. P.8 complained of genital abnormality. Her clitoridauxe resembled a micropenis. Both labia majora and labia minora were over-hypertrophic and resembled a scrotum, which appeared to fuse together with the micropenis. The urinary meatus was at the bottom of the micropenis, and the vaginal orifice could not be observed. P.9 was 1-year old and was admitted to the hospital because of genital abnormality. She had been diagnosed with hernia from an unknown origin. Her clitoridauxe resembled a micropenis, behind which the urinary meatus was observed. The vaginal orifice could not be observed. Labia majora and labia minora were normal.
‘Botched labiaplasty’: a content analysis of online advertising for revision labiaplasty
Published in Journal of Obstetrics and Gynaecology, 2020
Hazel Isabella Learner, Caroline Rundell, Lih-Mei Liao, Sarah M. Creighton
Further labial surgery will not address the gap between patient desires for highly specific anatomy and what is technically feasible. Nor will it address the sociocultural factors contributing to a patient’s conception of an acceptable genital appearance. There are limitations to what can be achieved with labia minora excision alone and it is important that surgeons ensure patients understand what can – and cannot – be achieved to avoid disappointment. Claims of guaranteed satisfaction contravene good clinical governance, no website answered what can be presumed to be the most pressing questions for women who are distressed about the results of their primary labiaplasty, that is, what exactly might have gone wrong, how the current providers may circumvent the problems, how many procedures have they carried out and what is the full range of outcomes from the consumers’ perspectives. Several of the providers described significant psychological distress after botched labiaplasty, including the risk of suicide. Some women reported to their surgeons that they feel ‘robbed of their femininity and womanhood’. Although in the absence of biomedical concerns, primary surgery is almost certainly based on psychological factors (e.g. poor body image), only one website described the role of psychological counselling as an alternative means for exploring the women’s distress.
Related Knowledge Centers
- Homology
- Vulva
- Clitoris
- Skin
- Labia Majora
- Urinary Meatus
- Vulval Vestibule
- Labia
- Penile Raphe
- Frenulum of Labia Minora