| INVASIVE SURGERY | ARTICLE
Figure 5 (A) Area of de-epithelisation of the inner aspect of both labia minora. (B) Area of de-epithelisation of the outer part of the left labia minora, with a ‘possible’ further area (marked at the border of the labia minora itself) of carefully calibrated resection (to be carried out — or not — at the end of the operation). (C) De-epithelisation accomplished in the outer part of left labia minora. (D) Result after suture completion of the de-epithelisation areas of the outer and inner aspects of the left labia minora. Of course, not a single suture catches both sides of de-epithelisation areas of each labia minora, but there are two (one inner and one outer) sutures for each labia minora. (E) Performing the de-epithelisation.
leaving a full thickness break (through the labia minora)
to be sutured. The difference of this technique to DavisonÕs is that the lymphatic drainage and the vascular and nerve supply would be resected in the bullÕs eye technique, but not in the technique the authors favour (Davison).
Contraindications No significant contraindications exist, but surgery cannot be performed if infectious diseases are present (i.e. sexual transmitted diseases, including herpes genitalis). Smoking is not a ÔrealÕ contraindication, but it is advised
that patients stop smoking 1 month before the operation, and continue cessation until 1-month post-operatively to avoid any adverse impact on vascular supply. A mandatory limitation is, of course, the minimum
requirement of 18 years of age for informed consent to be given.
Techniques Different surgical treatments are available. The easiest and most commonly used technique is the amputation of the hypertrophic portion of the labia minora, placing a clamp across the area of labia minora to be resected and
cutting away the outer part, often leaving an irregular outer edge, and potentially being complicated by neuroma, numbness, or paraesthesia. An example, from literature, of the immediate and late results of the ÔamputationÕ technique.
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