Labial Adhesions and Outcomes of Office Management

Spontaneous resolution of labial adhesions in pre‐pubertal girls

“…Previous studies on labial adhesion management have been conducted on cohorts with a median size of 49 participants (range 8–289) . Despite the retrospective classification of the extent of labial fusion, the classification is based on the proportion fused rather than an exact measurement of the opening allowed for comparison of labial adhesions at two different ages when labial size itself will have changed.…”

“…Some doctors also continue to treat in the absence of symptoms or parental concern . There is a large body of literature comparing different treatment modalities for labial adhesions, with widely variable results . However, little research addresses whether the condition actually causes the symptoms that have been attributed to it and the optimal management when symptoms or concerns are present.…”

“…Asymptomatic adhesions may be detected by maternal child health nurses or parents . Girls may then be referred to paediatricians or paediatric gynaecologists for a variety of reasons, including parental concern, suspected vaginal agenesis, imperforate hymen, local symptoms or the doctor's perception that labial adhesions require specialist management. Reported estimates of the incidence of labial adhesions in pre‐pubertal girls, both symptomatic and asymptomatic, range from 1.8 to 38.9% .…”

“…Furthermore, the proposed aetiology of labial adhesions, that is, inflammation of the labial epithelium with subsequent adherence, overlaps considerably with the aetiologies of these other conditions. Another common reason for girls to receive treatment for their adhesions is to alleviate parental concern due to the perception that their daughter's genitalia look ‘abnormal’ or the desire to ‘take action’ to resolve the condition …”

Demographic characteristics of labial adhesion in South Korea: a population-based study from 2010 to 2014

“… 2 LA is thought to be caused by the low-oestrogen environment, which easily results in vulvar inflammation and concomitant labial re-epithelialisation. 3 Numerous treatment options have been suggested with varying success rates. 4 …”