Do hygienic factors affect labial fusion recurrence? A search for possible related etiologic factors

Acer, Tuğba; Ötgün, İbrahim; Öztürk, Özge; Kocabaş, Tuğba; Tezcan, Aysu Yeşim; Çırak, Ayşenur; Öney, Merve Dilara; Kantar, Birce; Hiçsönmez, Akgün

doi:10.1016/j.jpedsurg.2012.05.005

Cited by 11 publications

(18 citation statements)

References 21 publications

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“…Decreased diaper use and increased ambulation allow for more physiologic separation of the labia minora, which reduces the possibility of adhesions (Table 1). 7 …”

Section: Pathophysiologymentioning

confidence: 99%

Clinical Recommendation: Labial Adhesions

Bacon

Romano

Quint

2015

Journal of Pediatric and Adolescent Gynecology

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“…Decreased diaper use and increased ambulation allow for more physiologic separation of the labia minora, which reduces the possibility of adhesions (Table 1). 7 …”

Section: Pathophysiologymentioning

confidence: 99%

Clinical Recommendation: Labial Adhesions

Bacon

Romano

Quint

2015

Journal of Pediatric and Adolescent Gynecology

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“…If no symptoms are present, some authors recommend reassurance and a watchful wait [ 2 ] and other authors recommend treatment in order to avoid symptoms [ 5 , 6 ]. Most authors recommend treatment as a result of symptoms [ 2 , 5 – 7 ].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Topical oestrogen ointment applied to the adhesion area is often used as a first-line treatment option [ 4 , 5 , 7 , 8 ]. Manual separation of the labia is often reported as a second-line treatment option when topical treatment fails [ 2 – 5 , 7 , 8 ] or when topical oestrogen therapy is refused by the child or parent [ 3 ]. In previous studies, the initial success rates after topical oestrogen treatment are reported to be 15–100% [ 2 – 5 , 7 ] and recurrence rates differ between 11 and 41% [ 4 , 5 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Treatment with oestrogen or manual separation for labial adhesions – initial outcome and long-term follow-up

2018

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BackgroundTopical oestrogen and manual separation are the main treatments for labial adhesions. The aim was to evaluate treatment of labial adhesions and compare the outcome of topical oestrogen treatment with that of manual separation.MethodAll girls aged 0–12 years admitted to a tertiary centre for paediatric surgery for labial adhesions were included. The study design was dual: The first part was a retrospective chart review of the treatment success according to the medical charts. The second part was a cross-sectional parent-reported long-term outcome study (> 6 months after last treatment finished).ResultsIn total 71 patients were included and the median follow-up time for the chart study was 84 (6–162) months after treatment with oestrogen or manual separation. Oestrogen was the first treatment for 66 patients who had an initial successful rate of 62% but this was followed by recurrences in 44%. Five patients had manual treatment as their first treatment and they had a 100% initial success rate followed by recurrences in 20%. Therefore, for the first treatment course there was a final success rate of 35% for oestrogen and 80% for manual separation (p = 0.006). Corresponding final success rates including all consecutive treatments over the study period were 46/130 (35%) for oestrogen and 21/30 (70%) for manual separation (p = 0.001). The success rate for oestrogen did not differ if treatment was given in a course length of 0–4 weeks (39% success) or > 4 weeks (32% success) (p = 0.369).In the parent-reported long-term outcome study the response rate was 51% (36/71).Parents reported that recurrences of adhesions after last prescribed/performed treatment were frequent: in total 25% of patients still had adhesions corresponding to 8/29 (29%) of those whose last treatment was oestrogen and 1/9 (11%) of those whose last treatment was manual separation.ConclusionDue to the results recurrences are common after both oestrogen and manual separations. However, the overall final outcome after manual separation seems to be more successful when compared to that of topical oestrogen treatment.

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“…13 Diferentes autores consideran que, en pacientes con enfermedad injerto contra huésped, la sinequia vulvar puede ser una de las manifestaciones a nivel cutáneo de esta entidad. 14 El factor presente en todos los casos es el daño superficial de la mucosa. 3 Las lesiones también son consecuencia de procesos infecciosos, como vulvitis o vulvovaginitis, 1 o mecánicos, como limpieza excesiva, 15 dermatitis grave por contaminación con heces 16 o posición de los labios menores con el uso del pañal.…”

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Sinequia vulvar: revisión de literatura

2017

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RESUMENLa fusión de los labios menores o sinequia vulvar es un hallazgo común y benigno. La incidencia se encuentra entre 0,3% y 3,3%. La edad de mayor incidencia es de los 3 meses a los 6 años. Objetivos. Realizar una revisión de la literatura internacional sobre factores de riesgo, etiología, tratamiento y pronóstico de la sinequia vulvar. Materiales y métodos. Búsqueda sistemática en bases de datos PubMed, Embase y ScienceDirect con revisiónde artículos de enero de 1999 a octubre de 2016. Resultados y conclusiones. La sinequia vulvar es una patología benigna multifactorial y existen pocos estudios en Latinoamérica. Las líneas de tratamiento son observación y seguimiento, medicación tópica y separación manual o quirúrgica. Los estrógenos conjugados presentan una tasa de éxito del 50-90% con recurrenciadel 30%; los corticoides tópicos tienen una tasa de éxito del68-80% yrecurrencia del 23%. La intervención posee una tasa de éxito del 100% y de recurrencia de 10%. Palabras clave: sinequia vulvar, factores de riesgo, tratamiento, pediatría. ABSTRACTFusion of the labia or sinequia vulvae is a common and benign finding in the pediatric female population. The reported incidence is 0.3-3.3% with a greater incidence between 3 months and 6 years old. Objective. Extensive review of the current international literature regarding the risk factors, etiology, treatment and prognosis. Material and methods. A systematic search in medical databases as PubMed, Embase and Science Direct for the papers published between January 1999 and October 2016. Results and conclusions. Labial adhesion is a multicausal benign pathology and there were very few published studies in Latin America. The proposed lines of treatment are observation and periodic follow up, topical treatment and manual or surgical separation. Topical conjugated estrogens have a success rate of 50-90% with recurrence of 30% and topical corticoids reported 68-80% of success with 23% of recurrences. Surgical intervention has a success rate of 100% and recurrence of 10%.

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Do hygienic factors affect labial fusion recurrence? A search for possible related etiologic factors

Cited by 11 publications

References 21 publications

Clinical Recommendation: Labial Adhesions

Clinical Recommendation: Labial Adhesions

Treatment with oestrogen or manual separation for labial adhesions – initial outcome and long-term follow-up

Sinequia vulvar: revisión de literatura

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