Spontaneous resolution of labial adhesions in pre‐pubertal girls

Norris, Jean E; Elder, Charlotte; Dunford, Angela; Rampal, Deepti; Cheung, Siu-Tim; Grover, Sonia

doi:10.1111/jpc.13847

Cited by 14 publications

(9 citation statements)

References 25 publications

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“…There are some reasons to think that way; first of all, LA is very uncommon in the newborn period when there is a period of mini-puberty. On the other hand, LA is very uncommon during the post-puberty when there are adequate estrogen levels (8). This estimate and studies are the main reason for the use of topical estrogen in labial fusion therapy.…”

Section: Discussionmentioning

confidence: 99%

Pre-pubertal labial adhesion surgery: The first study to compare manual or surgical separation

Hüseynov¹

2019

Ann Med Res

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Aim: Labial adhesion (LA) is one of the most common causes of admission to the pediatric surgery outpatient clinic among the prepubertal girls. There is no consensus on the best interventional technique (manual or surgical separation) for LA. The aim of this study is to compare the results of the manual and surgical separation of LA, and to decide which one is superior. Material and Methods: We reviewed the medical records of sixty-six patients with LA operated between July 2016 and Mart 2018 by the same surgeon. The patients were divided into two groups: patients treated with a manual separation technique (group 1) and with a surgical separation technique (group 2). Patients were evaluated regarding age at presentation, referral indication, symptoms, surgical technique, recurrence and time of recurrence. Results: There were 27 cases in Group 1 and 39 cases in Group 2. There were 14 recurrences in Group 1 (51.8%) and 5 recurrences in Group 2 (12.8%). The recurrence rate was significantly higher in Group 1. This difference between groups was statistically significant (p=0.0006). The relative risk for recurrence in Group 1 was found to be 4.0444 (OR 7.3231; p=0.0012), and 0.2473 in Group 2 with a significance level of p=0.0022. Conclusion: The treatment of labial adhesion with the surgical separation technique is superior to manual separation in terms of the possibility of recurrence. Additional prospective studies are still needed to strengthen these data.

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Section: Discussionmentioning

confidence: 99%

Pre-pubertal labial adhesion surgery: The first study to compare manual or surgical separation

Hüseynov¹

2019

Ann Med Res

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“…There are some reasons to think that way; first of all, LF is very uncommon in the newborn period when there is a period of mini-puberty. On the other hand, LF is very uncommon during the post-puberty when there are adequate estrogen levels (8). These estimates and studies are the main reason for the use of topical estrogen in LF therapy.…”

Section: Discussionmentioning

confidence: 99%

Interlabial fusion: As a new subtype of labial fusion

Hüseynov¹,

Cafarov²

2018

Ann Med Res

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Aim: to determine a new subtype of the labial fusion and to arrange treatment options according to this type. Material and Methods: We reviewed the medical records of patients with labial fusion, malodorous vaginal discharge and vulvar pruritus from July 2016 and August 2018 in pediatric surgery outpatient clinic. Anomalous fusion between labia minora and labia majora was observed in some patients, especially with vaginal discharge and pruritus. These patients were separated, characterized by common features and identified as a new subtype. Definition and Nomenclature: In this subtype, fusion is between the labia minora and majora, bilaterally. As the fusion is between the labia minora and labia majora, we prefer naming this condition as Interlabial (inter. lat=between) Fusion. Results: A total of 86 patients were included. Of this 86 patients 6 were admitted due to malodorous vaginal discharge and vulvar pruritus. Four of the six patients had abnormal adhesions between the labias. These patients were defined as interlabial fusion. Interlabial fusion was detected in only 4.7% of the patients. Topical steroid therapy was started in each of the four patients. All of the patients were fully recovered. Conclusion: Interlabial fusion is a rare condition, but it is not a separate disease. It is the result of different diseases affecting the genital area. It should be brought to mind in patients presenting with complaints of vaginal discharge and pruritus, especially if these complaints have recurred. Topical steroid therapy should be started as an initial treatment.

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“…A thin, membranous line can be seen where the labia join owing to the re-epithelialisation of the closely apposed tissues. 24 If symptomatic, the most bothersome complaints are urinary; with frequency, dribbling and infections leading to continuous vulval irritation. 25 Unfortunately, labial adhesions have occasionally been misdiagnosed as female genital mutilation (FGM), especially in those from backgrounds with a high reported prevalence of FGM.…”

Section: Labial Adhesionsmentioning

confidence: 99%

“…The diagnosis is made on clinical examination with the characteristic appearance of either partial or complete fusion of the labia minora, extending from the urethra to the posterior fourchette (Figure 5). A thin, membranous line can be seen where the labia join owing to the re‐epithelialisation of the closely apposed tissues 24 . If symptomatic, the most bothersome complaints are urinary; with frequency, dribbling and infections leading to continuous vulval irritation 25 …”

Section: Inflammatory and Infective Vulval Disorders In The Paediatri...mentioning

confidence: 99%

Vulval disorders in paediatric and adolescent patients and their management

Idle,

Coles,

Johns

2023

The Obstetric & Gynaecologis

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Key content Vulval disorders are one of the commonest complaints in the paediatric and adolescent population. They present with acute‐on‐chronic symptoms such as pruritus, vaginal discharge and vulval soreness. History‐taking and examination of young patients requires a sensitive approach and age‐appropriate use of language. The hypoestrogenic, exposed and neutral pH of the vulva in the paediatric patient is more susceptible to nonspecific inflammation and injury. Adolescents are more likely to present with dermatoses, thrush and infection caused by common pathogens such as Escherichia coli, group A streptococcus and sexually transmitted infections. A conservative approach with reassurance and follow‐up is required in most vulval disorders. Learning objectives To appreciate the different gynaecological history and examination techniques required for paediatric and adolescent patients. To understand the common presentations and conditions of vulval pathology in these groups of patients. To gain confidence in managing common, non‐malignant vulval pathology in young patients. Ethical issues Reassurance of normal vulval anatomy should be provided for young patients requesting labial reduction surgery.

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Spontaneous resolution of labial adhesions in pre‐pubertal girls

Cited by 14 publications

References 25 publications

Pre-pubertal labial adhesion surgery: The first study to compare manual or surgical separation

Pre-pubertal labial adhesion surgery: The first study to compare manual or surgical separation

Interlabial fusion: As a new subtype of labial fusion

Vulval disorders in paediatric and adolescent patients and their management

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