Aylin Kurt KARANLIK İstanbul Serbest hekim Labiaplasty’de yeni bir yöntem: geliştirilmiş inferior wedge rezeksiyon Aylin Kurt KARANLIK İstanbul Serbest hekim

Literatürdeki teknik tipleri Kenar eksizyon tekniği- trimming method (Caparo 1971- Felicio tarafından modifiye edilmiştir) Pediküllü flap ile wedge eksizyon(Alter 1998- Rouzier tarafından 2000’de Munhoz tarafından da 2006’da modifiye edilmiştir)

Santral eksizyon tekniği (Laub 2000) De-epitelizasyon tekniği (Choi ve Kim 2000) Santral eksizyon tekniği (Laub 2000)

W-şekilli (Maas-Hage 2000)

Wedge excision with pedicle flap . (Munhoz 2006) Central wedge nymphectomy with . a 90 degree Z-plasty (Giraldo- Gonzales 2004)

Patients From February 2009 t0 June 2011 Developed inferior wedge resection 157 patients Symmetrical hypertrophy ------- 151 (96%) patients Asymmetrical hypertrophy -------- 6 (4%) patients Postoperative complications Satisfaction results (by patient and surgeon)

Patient complaints Aesthetic concern 157 (%100) Poor hygiene 139 (%88,5) Difficulty wearing certain clothing 63 (%40,1) Pain with sexual activity 43 (%27,3) Chronic infection 14 (%8,9)

Ethiology *Congenital 139 (%88,6) *Acquired anomalies 18 (%11,4 ) -Hormonal imbalance 2 -Chronic irritation 14 -Urinary incontinance 1 -Manual stretching 1

Franco classification of labia minora hypertrophy Type Labial width (cm) Our patient 1 < 2 1 (%0,6) 2 2-4 3 (%1,9) 3 4-6 121 (%77,2) 4 >6 32 (%20.3) Total ------------------------------------------ 157 (100%)

Our technique

Results Median age 29 years (ranged 18-54) Hospital discharge = median 5 hours (3-20 h) Operative time = median 30 min (20-45 min)

Postoperative care 48 hours cold compression Personal hygiene after urinating Maintaining vulva and wounds dry Topical application of iodine Nitrofurzone ointment (Furacin©) to suture line Oral antibiotic, simple analgesia

Complication No intraoperative complications Postoperative complications Small dehiscence ------1 patient (healed spontaneously) Abscess ------------------1 patient (drainage)

Patient satistaction (overall) Very satistied ------ 114 (91%) Satisfied -----------11 (9%) Not satisfied -------0

Conclusions Easy and effective method Favourable aesthetic and functional outcomes Natural edge contour and color are preserved Minor complications

Thank you