Aesthetic and functional reduction of the labia minora using the Maas and Hage technique.

INTRODUCTION: Enlarged labia minora can cause functional, aesthetic and psychosocial problems. There are many reported techniques for their surgical correction in both the gynaecological and surgical literature suggesting that no one method is superior to the others. The problem is compounded because an individual surgeon's experience is likely to be small given the infrequent request for surgery. For these reasons it is important that existing techniques are validated by independent surgeons rather than describing yet another variation. METHODS: Patients who underwent surgical reduction of their labia minora from 2001-2008 were retrospectively reviewed. All cases were performed by the same surgeon using the Maas and Hage technique of a running interdigitating W-shaped excision. RESULTS: 12 patients aged from 15 to 52 years underwent reduction labioplasty for idiopathic hypertrophy. Postoperatively there were no wound dehiscences or infections. One patient developed a painful haematoma 2h after surgery necessitating surgical evacuation while another went into postoperative urinary retention relieved by overnight catheterisation. Both made uneventful recoveries. All patients were satisfied with their 'natural looking' cosmetic results and have returned to their normal activities without recurrence of their presenting symptoms. The mean follow up was 14 weeks but none have subsequently required or requested revisional surgery. CONCLUSIONS: The running W-shaped resection was found to be an easy and effective method of reducing the labia minora by a single operator in a small series of cases. This independent review demonstrates the reproducibility of this technique and the favourable aesthetic and functional outcomes for the patient.

High-pressure water jet injuries: a surgical emergency.

Injuries from high-pressure jet devices are surgical emergencies characterised by small entry wounds with extensive internal damage. Three factors are involved in these injuries. Physical injury can include local soft tissue disruption and vascular and nerve damage; chemical properties of the injectate can exacerbate compressive vascular injuries with increased oedema and inflammation; water-jet injuries can be contaminated by virulent organisms and foreign matter which can lead to unusual infections. Management is usually similar to that for injuries caused by high-velocity missiles, and involves aggressive debridement, irrigation and decompression followed by careful monitoring, and appropriate antibiotic therapy.