Gross vulval edema after laparoscopic instillation of 4% icodextrin solution

Severe vulval edema after laparoscopic ovarian cystectomy with instillation of adhesion-prevention solution (4% icodextrin) is a rare complication. A 17-year-old girl was readmitted to the hospital 2 days after laparoscopic ovarian cystectomy with massive vulval swelling, pain, and anxiety. Gross swelling was potentially caused by accumulation of fluid 4% icodextrin in the labia. The condition resolved spontaneously with application of ice packs and bed rest. Possible mechanisms of this complication are discussed as is the importance of adequate counseling and consent before surgery when adhesion prevention solutions are to be administered.