Materiały źródłowe

• #1 Labial Adhesion: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16435-labial-adhesions

  Labial adhesions have other names, which may be more informal or medical. These names include: […] Labial fusion. […] If your child has a labial adhesion, a healthcare provider may suggest a wait and see approach if they dont have any symptoms or problems peeing. […] If you or your child has symptoms, labial adhesion treatment may include: […] Topical treatments […] Manual or surgical separation […] Providers only surgically separate a labial adhesion if you cant pee and other treatments dont work. […] The outlook for labial adhesions is good. They often go away without treatment once your child begins menstruating. […] And remember, although rare, labial adhesions can also affect adults, especially during times in which their bodies dont produce as much estrogen.

• #2 Pediatric labial adhesions – Children’s Health Urology

  https://www.childrens.com/specialties-services/conditions/labial-adhesions

  Labial adhesions (labial – adhesions) occur when the inner vaginal lips known as the labia minora become stuck together. The area affected may be small or extensive. […] The condition affects an estimated one percent of all girls, generally between the ages of three months and six years. […] If your daughter has a labial adhesion, she may also experience: Urinary dribbling, Difficulty urinating or problems with urine leakage, Frequent bladder infections. Most girls have no symptoms. […] This condition may be discovered during a regular check-up and can be fully diagnosed through visual inspection. […] Though the cause of labial adhesions is unknown, irritation or inflammation of the labia possibly from wet diapers or certain soaps may cause them to fuse together, as well as the normal prepubertal low levels of estrogen, which affects the skin cells.

• #3 Labial Fusion (Adhesion on Genital Lips)

  https://www.eserdag.com/en/labial-fusion-adhesion-on-genital-lips

  Conditions such as diaper dermatitis, skin infections due to diapers, excessive irritation of the genital area, or inadequate cleaning can trigger labial adhesions. […] The incidence of labial fusion in infants is between 0.6-3%. […] Some of the labial fusion patients are completely asymptomatic; that is, they do not show any symptoms and are discovered incidentally during routine examinations. […] The diagnosis of labia fusion is based on gynecological examination of the genital area. […] The most common complaints in labial synechia are frequent urinary tract infections and frequent vaginal infections. […] When the level of labial adhesion (synechia) is severe, much worse complications such as urine accumulation in the bladder due to inability to empty the urine and leakage of urine to the kidney (vesicoureteral reflux) may occur.

• #4 Labial fusion

  https://www.nhs.uk/conditions/labial-fusion/

  Labial fusion, or labial adhesion, is when the small inner lips around the entrance to the vagina become sealed together. […] For most babies or girls, labial fusion does not cause any problems and is often discovered accidentally by a parent or carer during nappy changing or bathing. […] Treatment for labial fusion is not recommended unless there are other symptoms, such as dribbling after peeing, which may cause problems or discomfort. […] Surgery is very rarely needed to treat labial fusion. […] Labial fusion is not linked to any medical condition and has no long-term implications for your child. […] It will not affect her future fertility or sexual life. In most cases, a fusion corrects itself during puberty.

• #5 Labial fusion

  https://www.rch.org.au/kidsinfo/fact_sheets/Labial_fusion/

  Labial fusion is a condition where the two flaps of skin on either side of the opening to the vagina (the labia minora) are joined together. It is also sometimes called labial adhesion or agglutination. Labial fusion is a common condition, and there is no need for concern in most cases. […] The fusion (join) will usually separate by itself by the time your child reaches puberty. Treatment is not usually needed or recommended because it can cause your child pain and anxiety. There is also a risk that the fusion will return if any treatment is carried out. […] Labial fusion is almost never present at birth, but usually develops around one to two years of age. If your child has labial fusion, instead of two separate labia, you will be able to see the labia joined together. There are not usually any other symptoms.

• #6 Labial Adhesions – MD Searchlight

  https://mdsearchlight.com/womens-health/labial-adhesions/

  Labial fusion, which is the joining of the lips around the vulva, often doesn’t show obvious signs or symptoms. It’s usually accidentally discovered during a routine check-up. This fusion usually happens near the clitoris and involves thin fibrotic tissue a kind of scar tissue. This fusion can be slight or complete, even blocking the entrance to the vagina. […] Women with this condition may also experience difficulty urinating or holding urine. Additionally, labial fusion might be linked with urinary tract infections (UTIs), leading to the need for treatment. Research suggests that women with labial fusion before puberty have an increased risk of UTIs. This makes it very important to conduct a physical exam, particularly of the genitourinary region. If labial adhesions are successfully resolved, the risk of UTIs can go down.

• #7 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470461/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. It also may be known as synechia vulvae or labial agglutination. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. Therefore, these patients are typically managed with estrogen cream when symptomatic. […] Labial adhesions are managed by an interprofessional team that includes the pediatrician, nurse practitioner, and primary care provider. The diagnosis is made on a clinical examination and the treatment depends on symptoms. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. One of the major indications for treatment is a urinary tract infection. Some studies have demonstrated a success rate of up to 90% with the use of topical estrogen cream. In rare cases, surgical release of the adhesions may be required. […] Recurrences are common with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty. Some studies report a rate of recurrence from 11% to 14% with either topical or surgical management.

• #8 Labial Adhesions: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/953412-overview

  Labial adhesions (also referred to as labial agglutination) are a common disorder in prepubertal females, who are hypoestrogenic. This disorder is usually asymptomatic and is often first noticed by parents or during a routine physical examination. Labial adhesions occur most frequently between the ages of 3 months and 6 years. They may be more common in the setting of vulvovaginitis. […] Treatment of labial adhesions is typically conservative. Labial adhesions can often be managed with periodic observation; spontaneous resolution may occur and commonly occurs during puberty. Further management considerations are as follows: If treatment is necessitated by symptoms or parental requests such as frequent UTIs, topical estrogen cream is indicated. If medical care does not result in separation of the labia or if urinary retention or UTIs are present, manual or surgical separation may be considered.

• #9 Labial Fusion (Adhesion on Genital Lips)

  https://www.eserdag.com/en/labial-fusion-adhesion-on-genital-lips

  Conditions such as diaper dermatitis, skin infections due to diapers, excessive irritation of the genital area, or inadequate cleaning can trigger labial adhesions. […] The incidence of labial fusion in infants is between 0.6-3%. […] Some of the labial fusion patients are completely asymptomatic; that is, they do not show any symptoms and are discovered incidentally during routine examinations. […] The diagnosis of labia fusion is based on gynecological examination of the genital area. […] The most common complaints in labial synechia are frequent urinary tract infections and frequent vaginal infections. […] When the level of labial adhesion (synechia) is severe, much worse complications such as urine accumulation in the bladder due to inability to empty the urine and leakage of urine to the kidney (vesicoureteral reflux) may occur.

• #10 Pediatric labial adhesions – Children’s Health Urology

  https://www.childrens.com/specialties-services/conditions/labial-adhesions

  Labial adhesions (labial – adhesions) occur when the inner vaginal lips known as the labia minora become stuck together. The area affected may be small or extensive. […] The condition affects an estimated one percent of all girls, generally between the ages of three months and six years. […] If your daughter has a labial adhesion, she may also experience: Urinary dribbling, Difficulty urinating or problems with urine leakage, Frequent bladder infections. Most girls have no symptoms. […] This condition may be discovered during a regular check-up and can be fully diagnosed through visual inspection. […] Though the cause of labial adhesions is unknown, irritation or inflammation of the labia possibly from wet diapers or certain soaps may cause them to fuse together, as well as the normal prepubertal low levels of estrogen, which affects the skin cells.

• #11 Labial adhesions in adult women. Labial fusion

  https://dermnetnz.org/topics/labial-adhesion-adult-women

  Labial adhesion means that the labia minora are stuck together or fused. Adhesion rarely results in complete labial fusion; more often it is partial. […] Secondary labial adhesion usually occurs after menopause. Labial adhesion in prepubertal girls is often present since birth and is known as primary labial adhesion. […] The most common causes of labial adhesion in adult women are listed below. […] Labial adhesion joining the left and right labia minora results in a narrowed vaginal opening (the vaginal introitus). […] Symptoms may be absent or the adhesion may lead to: Painful sex (dyspareunia). […] Partial labial adhesion may be unobserved but often, symptoms and complications arise. […] Complete labial fusion means that urine and vaginal fluids including menstrual blood build up behind the fused labia; this is an emergency and urgent medical assistance should be sought. […] Treatment depends on the cause of the fusion. It does not always require specific treatment.

• #12

  https://journals.lww.com/jomh/fulltext/2024/15030/labial_fusion_in_a_postmenopausal_woman_presenting.16.aspx

  Genitourinary syndrome of menopause refers to the collection of signs and symptoms associated with decrease in estrogen and other sex steroids involving changes in labia majora/minora, clitoris, vestibule/introitus, vagina, urethra, and bladder. […] Labial fusion refers to the complete or partial fusion of labia minora in the midline due to adhesions. […] In the postmenopausal stage, low estrogen levels render the genital area more prone to irritation and inflammation leading to labial fusion. […] Management protocol at the early stage includes topical estrogen therapy and treatment of predisposing factors, whereas refractory cases need surgical separation. […] Complete labial fusion is a rare presentation of GSM. Patient embarrassment is one of the major reasons behind it remaining undiagnosed and untreated.

• #13 Pediatric labial adhesions – Children’s Health Urology

  https://www.childrens.com/specialties-services/conditions/labial-adhesions

  Labial adhesions (labial – adhesions) occur when the inner vaginal lips known as the labia minora become stuck together. The area affected may be small or extensive. […] The condition affects an estimated one percent of all girls, generally between the ages of three months and six years. […] If your daughter has a labial adhesion, she may also experience: Urinary dribbling, Difficulty urinating or problems with urine leakage, Frequent bladder infections. Most girls have no symptoms. […] This condition may be discovered during a regular check-up and can be fully diagnosed through visual inspection. […] Though the cause of labial adhesions is unknown, irritation or inflammation of the labia possibly from wet diapers or certain soaps may cause them to fuse together, as well as the normal prepubertal low levels of estrogen, which affects the skin cells.

• #14 Labial Adhesions | Texas Pediatric and Adolescent Gynecology | TPAG

  https://www.texaspediatricgynecology.com/labial-adhesions.html

  About 2% of female children will develop labial adhesions before they reach puberty. At Texas Pediatric Adolescent Gynecology, Oluyemisi Adeyemi-Fowode, MD, and the team offer physical exams on-site to confirm labial lesions. Conservative therapies and minimally invasive surgeries are available to address symptoms like vaginal pain and difficulties urinating caused by labial adhesions. […] When the labial tissues block the vaginal opening or cause symptoms that interfere with your daughters health or quality of life, you should schedule a diagnostic evaluation with the team at Texas Pediatric Adolescent Gynecology. […] Labial adhesions may not cause symptoms in infants or young girls. However, as girls get older, they may complain of vaginal pain, difficulty urinating, vaginal discharge, and frequent urinary tract infections (UTIs).

• #15 Labial Adhesions | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/labial-adhesion/

  Labial adhesion or labial agglutination occurs when the small, inner lips (labia minora) of the outside of the vagina (vulva) get stuck or fused together and cover the vaginal opening. Labial adhesions can range in severity from completely covering the vaginal opening to only partially covering it. […] Labial adhesions typically occur in infants and young girls when estrogen levels are low and genital tissues are sensitive. […] Labial adhesions typically occur in infants and young girls before the onset of puberty. Once girls enter puberty and estrogen levels increase, labial adhesions are much less common, and the labia minora can sometimes separate on their own. […] Many girls with labial adhesions will not have symptoms. Some girls will experience genital pain, urinary tract infections or have difficulty urinating.

• #16 Labial adhesions in adult women. Labial fusion

  https://dermnetnz.org/topics/labial-adhesion-adult-women

  Labial adhesion means that the labia minora are stuck together or fused. Adhesion rarely results in complete labial fusion; more often it is partial. […] Secondary labial adhesion usually occurs after menopause. Labial adhesion in prepubertal girls is often present since birth and is known as primary labial adhesion. […] The most common causes of labial adhesion in adult women are listed below. […] Labial adhesion joining the left and right labia minora results in a narrowed vaginal opening (the vaginal introitus). […] Symptoms may be absent or the adhesion may lead to: Painful sex (dyspareunia). […] Partial labial adhesion may be unobserved but often, symptoms and complications arise. […] Complete labial fusion means that urine and vaginal fluids including menstrual blood build up behind the fused labia; this is an emergency and urgent medical assistance should be sought. […] Treatment depends on the cause of the fusion. It does not always require specific treatment.

• #17

  https://link.springer.com/article/10.1007/BF01956155

  Thirty-three female children with labial fusion were screened for bacteriuria which was defined as the growth of a single micro-organism with 100 000 colony-forming units/ml (100106 colonies/l) in a properly collected urine specimen. Six girls were found to have bacteriuria. In contrast, none of the 33 girls in a control group had bacteriuria. We recommend that a urine culture be performed in girls with labial fusion and that all girls with bacteriuria should be checked for labial fusion. […] Leung AK, Robson WL (1992) Labial fusion and urinary tract infection. Child Nephrol Urol 12:6264. […] Podolsky ML (1973) Labial fusion: a cause of recurrent urinary tract infections. Clin Pediatr 12:345346.

• #18 Labial Fusion

  https://www.patientcareonline.com/view/labial-fusion

  A 2-year-old girl presented with a 2-day history of urinary frequency and dysuria. Physical examination revealed complete fusion of the labia minora. […] Labial fusion refers to partial or complete adherence of the labia minora; it occurs most commonly in girls between ages 3 months and 4 years. […] Girls with labial fusion are prone to urinary tract infection, since stagnant urine retained behind the fused labia encourages the growth of bacteria. A urinalysis and urine culture should therefore be obtained in these children. Conversely, all girls with significant bacteriuria or urinary tract infection should be checked for labial fusion. If labial fusion persists beyond puberty, problems with sexual intercourse may result. […] Treatment consists of topical application of an estrogen cream once or twice a day until the adhesion has lysed. After separation of the labia minora, a nonpharmacologic ointment such as petrolatum is applied daily to the labia minora for at least a month to prevent readhesion.

• #19 Labial Adhesions | Riley Children’s Health

  https://www.rileychildrens.org/health-info/labial-adhesions-vaginitis

  Labial adhesions occur when the inner lips (labia minora) of the vulva (outside of the vagina) stick together. This occurs most often in girls between 3 months and 6 years of age. […] A pediatrician or healthcare provider may diagnose labial adhesion during a regular examination. An adhesion shows itself as a white line in the vulvar area. The vaginal and urethral (pee channel) opening may be partially or fully covered by the labia. […] Your child’s pediatrician may monitor smaller, milder adhesions that do not cause symptoms. In most cases labial adhesions disappear within a year after diagnosis without any treatment. […] Treatment for labial adhesions can include: 1) application of a mild emollient with manual pressure, 2) application of an estrogen-based or steroid cream or 3) manual separation by a pediatric urologist. […] Until a girl reaches puberty and estrogen levels increase, labial adhesions may occur more than once, and daily ointment application for 6 to 12 months may decrease recurrence.

• #20 Labial Adhesions – MD Searchlight

  https://mdsearchlight.com/womens-health/labial-adhesions/

  Labial fusion, which is the joining of the lips around the vulva, often doesn’t show obvious signs or symptoms. It’s usually accidentally discovered during a routine check-up. This fusion usually happens near the clitoris and involves thin fibrotic tissue a kind of scar tissue. This fusion can be slight or complete, even blocking the entrance to the vagina. […] Women with this condition may also experience difficulty urinating or holding urine. Additionally, labial fusion might be linked with urinary tract infections (UTIs), leading to the need for treatment. Research suggests that women with labial fusion before puberty have an increased risk of UTIs. This makes it very important to conduct a physical exam, particularly of the genitourinary region. If labial adhesions are successfully resolved, the risk of UTIs can go down.

• #21 Labial Fusion

  https://www.patientcareonline.com/view/labial-fusion

  A 2-year-old girl presented with a 2-day history of urinary frequency and dysuria. Physical examination revealed complete fusion of the labia minora. […] Labial fusion refers to partial or complete adherence of the labia minora; it occurs most commonly in girls between ages 3 months and 4 years. […] Girls with labial fusion are prone to urinary tract infection, since stagnant urine retained behind the fused labia encourages the growth of bacteria. A urinalysis and urine culture should therefore be obtained in these children. Conversely, all girls with significant bacteriuria or urinary tract infection should be checked for labial fusion. If labial fusion persists beyond puberty, problems with sexual intercourse may result. […] Treatment consists of topical application of an estrogen cream once or twice a day until the adhesion has lysed. After separation of the labia minora, a nonpharmacologic ointment such as petrolatum is applied daily to the labia minora for at least a month to prevent readhesion.

• #22 Endoscopic examination of labial fusion in a postmenopausal woman: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-018-1568-4

  Labial fusion is defined as adhesions of the labia minora or majora. Labial fusion may cause urinary retention. Surgical treatment based on an accurate anatomic assessment may be needed, but the usefulness of endoscopic examination for this disease has not been reported. […] We present a case of a postmenopausal patient with labial fusion who underwent successful surgical management. An endoscopic examination enabled us to determine the precise anatomic position and adopt a safe surgical procedure. […] Labial fusion is a benign genital disorder which is most commonly described in prepubertal girls, and less often reported in postmenopausal women. […] Surgical treatment is needed if a patient complains of urination disorders or the degree of labial fusion is severe. […] Although an endoscopic examination is frequently performed in the diagnosis and treatment of lower and upper urinary tract disease, the use of cystoscopy in patients with labial fusion and urinary retention has not been reported.

• #23 Endoscopic examination of labial fusion in a postmenopausal woman: a case report | Journal of Medical Case Reports | Full Text

  https://jmedicalcasereports.biomedcentral.com/articles/10.1186/s13256-018-1568-4

  The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] In this report, we present a case of a postmenopausal patient with esophageal cancer who had an abnormal finding involving the vagina on a PET scan. The diagnosis of labial fusion can be made by inspection, but endoscopic examination was shown to be invaluable to determine the precise anatomic structures and relationships, thus enabling us to perform a safe surgical procedure.

• #24 Labial Adhesions Treatment & Management: Approach Considerations, Topical Agents and Emollients, Manual or Surgical Separation

  https://emedicine.medscape.com/article/953412-treatment

  Labial adhesions can often be managed with periodic observation, and spontaneous resolution has been reported in as many as 80% within 1 year. Most will resolve once endogenous estrogen production begins. […] If treatment is necessitated by symptoms or blockage of most of the vaginal opening, topical estrogen cream is indicated. If medical care does not result in separation of the labia minora or if labial adhesions are severe and associated with urinary retention, manual or surgical separation may be considered. […] Primary treatment of labial adhesions consists of applying topical estrogen cream (conjugated estrogen cream or estradiol vaginal cream 0.01%) directly onto the area of adhesions of the labia minora. The cream can be applied to the adhesions two or three times daily for several weeks. Once the adhesions start to separate, the application frequency can be decreased and application of an emollient added.

• #25 Labial Adhesions: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/953412-overview

  Labial adhesions (also referred to as labial agglutination) are a common disorder in prepubertal females, who are hypoestrogenic. This disorder is usually asymptomatic and is often first noticed by parents or during a routine physical examination. Labial adhesions occur most frequently between the ages of 3 months and 6 years. They may be more common in the setting of vulvovaginitis. […] Treatment of labial adhesions is typically conservative. Labial adhesions can often be managed with periodic observation; spontaneous resolution may occur and commonly occurs during puberty. Further management considerations are as follows: If treatment is necessitated by symptoms or parental requests such as frequent UTIs, topical estrogen cream is indicated. If medical care does not result in separation of the labia or if urinary retention or UTIs are present, manual or surgical separation may be considered.

• #26 Labial Adhesions Treatment & Management: Approach Considerations, Topical Agents and Emollients, Manual or Surgical Separation

  https://emedicine.medscape.com/article/953412-treatment

  Labial adhesions can often be managed with periodic observation, and spontaneous resolution has been reported in as many as 80% within 1 year. Most will resolve once endogenous estrogen production begins. […] If treatment is necessitated by symptoms or blockage of most of the vaginal opening, topical estrogen cream is indicated. If medical care does not result in separation of the labia minora or if labial adhesions are severe and associated with urinary retention, manual or surgical separation may be considered. […] Primary treatment of labial adhesions consists of applying topical estrogen cream (conjugated estrogen cream or estradiol vaginal cream 0.01%) directly onto the area of adhesions of the labia minora. The cream can be applied to the adhesions two or three times daily for several weeks. Once the adhesions start to separate, the application frequency can be decreased and application of an emollient added.

• #27 LABIAL FUSION – Care of Children

  https://careofchildren.com/labial-fusion/

  Labial fusion is common in young girls. It is the term used to describe the condition when the two sides of the labia stick or join together. Treatment is not usually needed or recommended because it can cause your daughter more pain and anxiety. There is also a risk that the fusion will return if any treatment occurs. […] The join (or fusion) usually separates naturally by the time your daughter has her first period. This happens slowly. There is no pain and she will not notice it happening. Medical treatment, massage or cream is not usually needed. […] Medical treatment to pull apart the labia is not recommended, as there is a high risk that the adhesion or fusion will return. The procedure can be painful and your daughter might grow up worrying that there is something wrong with her. Leaving it alone is the safest and most effective treatment. […] Labial fusion does not have any effect on future fertility. As an adult, your daughter will be able to have sex and be able to have children the same as other women. […] The safest, most effective and least stressful thing to do is no treatment.

• #28 Labial Adhesions – MD Searchlight

  https://mdsearchlight.com/womens-health/labial-adhesions/

  If a patient does not show any symptoms, treatment is not required. The best course of action is to simply reassure the patient and their family and provide guidance on maintaining good hygiene. Labial adhesions, which is when the inner lips of the female genital area stick together, often resolve on their own within a year without any treatment, as it happens in around 80% of the cases. […] However, when treatment is needed, it usually involves applying a type of cream that contains estrogen directly to the area. This method is often adopted when the patient has a urinary tract infection. Research has shown this approach to be successful in up to 90% of the cases. […] Remember that regardless of the type of treatment used, labial adhesions can reoccur. They may continue to return until the female patient goes through puberty. Studies show that recurrence rates range from 11% to 14% with either topical or surgical treatments. Any recurrences can be managed with topical treatment or surgery. In some cases, manual separation accompanied by good hygiene practices and cleanliness could also be an effective treatment option.

• #29 Labial fusion

  https://www.rch.org.au/kidsinfo/fact_sheets/Labial_fusion/

  Treatment is not usually needed. If the labial fusion is causing significant problems (e.g. problems urinating), treatment options may include gentle massage or applying oestrogen cream. Surgery to pull apart the labia is a last resort, but it is not recommended as there is a high risk that the fusion will return. […] Leaving labial fusion alone is the safest and most effective treatment. […] Labial fusion will not have any effect on your child’s future ability to have sexual intercourse or have babies. […] The safest, most effective and least stressful thing to do is no treatment.

• #30 Labial Adhesions Treatment & Management: Approach Considerations, Topical Agents and Emollients, Manual or Surgical Separation

  https://emedicine.medscape.com/article/953412-treatment

  Labial adhesions can often be managed with periodic observation, and spontaneous resolution has been reported in as many as 80% within 1 year. Most will resolve once endogenous estrogen production begins. […] If treatment is necessitated by symptoms or blockage of most of the vaginal opening, topical estrogen cream is indicated. If medical care does not result in separation of the labia minora or if labial adhesions are severe and associated with urinary retention, manual or surgical separation may be considered. […] Primary treatment of labial adhesions consists of applying topical estrogen cream (conjugated estrogen cream or estradiol vaginal cream 0.01%) directly onto the area of adhesions of the labia minora. The cream can be applied to the adhesions two or three times daily for several weeks. Once the adhesions start to separate, the application frequency can be decreased and application of an emollient added.

• #31 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470461/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. It also may be known as synechia vulvae or labial agglutination. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. Therefore, these patients are typically managed with estrogen cream when symptomatic. […] Labial adhesions are managed by an interprofessional team that includes the pediatrician, nurse practitioner, and primary care provider. The diagnosis is made on a clinical examination and the treatment depends on symptoms. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. One of the major indications for treatment is a urinary tract infection. Some studies have demonstrated a success rate of up to 90% with the use of topical estrogen cream. In rare cases, surgical release of the adhesions may be required. […] Recurrences are common with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty. Some studies report a rate of recurrence from 11% to 14% with either topical or surgical management.

• #32

  https://www.healthychildren.org/English/health-issues/conditions/genitourinary-tract/Pages/Labial-Adhesions.aspx

  Good hygiene, such as giving your child daily sitz baths, is also important in the treatment and prevention of labial adhesions. […] It is important to keep in mind that the estrogen cream may result in temporary changes in the appearance of the hymen (tissue at the opening of the vagina) or withdrawal bleeding (like a period).

• #33 Labial Adhesions Treatment & Management: Approach Considerations, Topical Agents and Emollients, Manual or Surgical Separation

  https://emedicine.medscape.com/article/953412-treatment

  Labial adhesions can often be managed with periodic observation, and spontaneous resolution has been reported in as many as 80% within 1 year. Most will resolve once endogenous estrogen production begins. […] If treatment is necessitated by symptoms or blockage of most of the vaginal opening, topical estrogen cream is indicated. If medical care does not result in separation of the labia minora or if labial adhesions are severe and associated with urinary retention, manual or surgical separation may be considered. […] Primary treatment of labial adhesions consists of applying topical estrogen cream (conjugated estrogen cream or estradiol vaginal cream 0.01%) directly onto the area of adhesions of the labia minora. The cream can be applied to the adhesions two or three times daily for several weeks. Once the adhesions start to separate, the application frequency can be decreased and application of an emollient added.

• #34 Labial Adhesion: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16435-labial-adhesions

  Labial adhesions have other names, which may be more informal or medical. These names include: […] Labial fusion. […] If your child has a labial adhesion, a healthcare provider may suggest a wait and see approach if they dont have any symptoms or problems peeing. […] If you or your child has symptoms, labial adhesion treatment may include: […] Topical treatments […] Manual or surgical separation […] Providers only surgically separate a labial adhesion if you cant pee and other treatments dont work. […] The outlook for labial adhesions is good. They often go away without treatment once your child begins menstruating. […] And remember, although rare, labial adhesions can also affect adults, especially during times in which their bodies dont produce as much estrogen.

• #35 Labial Adhesions | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/labial-adhesions

  Labial adhesions occur when the labia minora adhere together forming a shiny membrane of inflammatory tissue. […] Since many girls have no symptoms, no treatment may be necessary. Adhesions will resolve on their own during puberty as the estrogen levels increase. […] Lysing (breaking down) the adhesions is necessary if the adhesions are causing symptoms. Different options are available and the decision as to which approach to take will depend on your child’s condition and her healthcare provider. […] One option is to simply apply Vaseline with pressure to the adhesions. Over time, the pressure and the Vaseline may be enough to separate the adhesion. Estrogen cream (premarin cream) can also be applied. […] Manually breaking down the adhesions in the office, after applying a topical anesthetic cream, may be another approach for your child. If your provider recommends, this can also take place under a short general anesthesia in the operating room if the adhesions are very thick.

• #36 Labial Adhesions | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/labial-adhesions

  Labial adhesions occur when the labia minora adhere together forming a shiny membrane of inflammatory tissue. […] Since many girls have no symptoms, no treatment may be necessary. Adhesions will resolve on their own during puberty as the estrogen levels increase. […] Lysing (breaking down) the adhesions is necessary if the adhesions are causing symptoms. Different options are available and the decision as to which approach to take will depend on your child’s condition and her healthcare provider. […] One option is to simply apply Vaseline with pressure to the adhesions. Over time, the pressure and the Vaseline may be enough to separate the adhesion. Estrogen cream (premarin cream) can also be applied. […] Manually breaking down the adhesions in the office, after applying a topical anesthetic cream, may be another approach for your child. If your provider recommends, this can also take place under a short general anesthesia in the operating room if the adhesions are very thick.

• #37 Release of Labia Fusion

  https://atlasofpelvicsurgery.org/1VulvaandIntroitus/14releaseoflabialfusion/chap1sec14.html

  Release of Labial Fusion […] Labial fusion is secondary to a urogenital sinus deformity, and in the majority of cases the labia separate on their own or with applications of estrogen cream. There are, however, some cases where the fusion is not amenable to conservative management and surgical intervention is required. […] Only after the patient has been adequately evaluated should surgical management be started. […] The fused labia are opened, resulting in a normal vaginal canal. […] Care should be taken to identify all genital canals within the pelvis. […] A large sound is passed into the orifice of the urogenital sinus, and a scalpel is used to open the median raphe. […] When the last suture has been placed, the normal female anatomy is essentially restored.

• #38 Labial Adhesions Treatment & Management: Approach Considerations, Topical Agents and Emollients, Manual or Surgical Separation

  https://emedicine.medscape.com/article/953412-treatment

  A 2007 literature review reported that the success rate of topical estrogen intervention in girls with labial adhesions was typically about 90%, with published success rates ranging from 46.7% to 100% in case series reports. […] Postoperatively, to prevent recurrence, the patient or a parent must apply an emollient to the separated labia minora several times daily for 3-4 months. A study by Morin et al cited a recurrence rate of 9% (2/22) after surgical treatment of labial adhesions (median follow-up, 4.3 mo). […] Once the labial adhesions have been separated, either by medical means or through surgical treatment, an emollient (eg, antibiotic ointment or diaper rash cream) should be applied several times a day for several months to allow the labial edges to heal without repeat adhesion formation.

• #39 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470461/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. It also may be known as synechia vulvae or labial agglutination. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. Therefore, these patients are typically managed with estrogen cream when symptomatic. […] Labial adhesions are managed by an interprofessional team that includes the pediatrician, nurse practitioner, and primary care provider. The diagnosis is made on a clinical examination and the treatment depends on symptoms. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. One of the major indications for treatment is a urinary tract infection. Some studies have demonstrated a success rate of up to 90% with the use of topical estrogen cream. In rare cases, surgical release of the adhesions may be required. […] Recurrences are common with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty. Some studies report a rate of recurrence from 11% to 14% with either topical or surgical management.

• #40 Labial Adhesions: Practice Essentials, Pathophysiology and Etiology, Epidemiology

  https://emedicine.medscape.com/article/953412-overview

  The prognosis for girls with labial adhesions is excellent. If left untreated, the condition usually resolves spontaneously at puberty. Labial adhesions are generally asymptomatic and are not a common cause of urologic or gynecologic morbidity. In rare cases, they can cause urinary outflow deflection or obstruction, leading to vaginal reflux of urine and subsequent vaginal leaking when the child stands after voiding. Recurrence of labial adhesions is common and has been reported in as many as 11.6-14% of cases; however, the true recurrence rate may be higher with longer follow-up. […] To decrease the risk that labial adhesions will recur after having been opened either by use of estrogen cream or by manual separation, an emollient should be used several times a day for several months.

• #41 Labial Adhesions | Texas Children’s

  https://www.texaschildrens.org/content/conditions/labial-adhesions

  Labial adhesions occur when the vaginal lips – known as the labia – become stuck together. The area stuck together may be small or extensive. […] Treatment depends on the individual and the severity of their condition. Never force the labia apart. It will be painful and traumatic to the child and cause the adhesions to recur (possibly worse than the original adhesions). […] Treatment strategies include: For mild cases – where the vaginal opening is not covered and there are no symptoms, the condition may be left alone to resolve or separate on its own over time. For moderate cases – where the lower part of the vagina may be covered, treatment may involve several weeks of a mild ointment and gentle separation. For more severe cases – where the vaginal and possibly the urinary opening are covered, an estrogen cream may be prescribed to help dissolve the tissue and separate the labia. […] Labial adhesions can develop again. To keep the labia open, avoid irritants such as wet diapers and scented soaps/detergents and apply a lubricant like petroleum jelly to the labia.

• #42 Labial Adhesions – Kidshealth | Akron Children’s

  https://www.akronchildrens.org/kidshealth/en/parents/labial-adhesions.html

  Also called: Labial Fusion, Labial Agglutination, Synechia Vulvae […] Labial adhesions happen when the labia minora (the inner folds of skin surrounding the vaginal opening) become fused together. In most cases, only a small part of the labia is fused, so the adhesions usually dont cause any problems. […] Labial adhesions will go away on their own during puberty if not well before that. They only need medical treatment if a large part of the labia is fused or the adhesions cause problems (such as trouble peeing or infections). […] If treatment is needed, doctors prescribe an estrogen or steroid cream to help the adhesions come apart. […] To prevent the labia from growing back together after the adhesions part, put white petroleum jelly on the area twice a day for 612 months. After your child finishes puberty, the labial adhesions aren’t likely to come back. […] Because irritation to the labia can make the adhesions worse or cause them to come back: Keep the genital area clean […] Labial adhesions do not cause any lasting problems. Later in life, they wont affect your childs sexuality or fertility (ability to have children).

• #43 Labial adhesions in prepubertal girls. Labial fusion

  https://dermnetnz.org/topics/labial-adhesion-prepubertal-girls

  Labial adhesion means the labia minora are stuck together. This is sometimes called 'labial fusion’. […] Primary labial adhesion most commonly affects prepubertal girls aged 3 months to 8 years. […] If treatment is necessary, oestrogen cream may be prescribed to apply to the labia and is usually successful. […] It is not always possible to prevent labial adhesion. Minimise contact with irritants. Use non-soap cleanser or water alone. Avoid bubble baths.

• #44

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zx4356

  The labia are the small lips around the opening of the vagina and urethra. Labial adhesion means that those lips have joined together instead of staying apart. […] This is common in girls, especially those younger than 6 years. It often causes no symptoms and will go away by itself. But it may cause symptoms such as pain or urinary problems. If so, you can treat it with a prescription cream. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Don’t try to separate the labia yourself. […] If your doctor has prescribed a prescription cream, follow the doctor’s directions about how often to apply it and how long to use it. […] Call your doctor or nurse advice line now or seek immediate medical care if your child has symptoms of a urinary infection, such as: Blood or pus in the urine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if there is no change in the adhesion after several weeks.

• #45 Labial agglutination

  https://www.aboutkidshealth.ca/labialagglutination

  Labial agglutination occurs when the skin around the vagina sticks together. […] Sometimes a health-care provider will prescribe estrogen cream to help the labia to open. […] Barrier creams, such as petroleum jelly and zinc oxide, can also help. […] If your child has labial agglutination, their health-care provider will want to make sure they can urinate without problems, and that there are no other problems with the vagina or the skin around it. […] Your child’s health-care provider may give you medicated cream to treat labial agglutination. […] Sometimes children with labial agglutination are prescribed a hormone cream containing estrogen or a steroid cream. […] Labial agglutination can come back. […] To stop it from coming back, keep using barrier creams such as petroleum jelly and zinc oxide on the labia. […] Do not try to pull or force the labia open in any way. […] Zinc oxide or petroleum jelly (Vaseline) cream can be applied two to three times a day to keep the skin moist. […] Estrogen cream, petroleum jelly or zinc oxide should be put on after the bath.

• #46 Labial adhesion – diagnostics and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2017/01/original-article/labial-adhesion-diagnostics-and-treatment

  Labial adhesion is relatively common, but the condition is little known among doctors and parents. The article assesses treatment in the specialist health service. Treatment for labial adhesion had a limited effect in this study. As the literature suggests that the condition results in few symptoms and resolves spontaneously in virtually all girls in puberty, no compelling medical reason exists for opening the adhesion in asymptomatic girls. It is important that doctors are aware of the condition in order to prevent misdiagnosis and to provide parents with adequate information. For parents it is important to know that spontaneous resolution may result in soreness and dysuria. Knowledge of the condition can most likely prevent unnecessary worry. The vast majority of girls with labial adhesion are asymptomatic, and this is the case irrespective of age. However, the condition may be associated with various symptoms, for example a stinging pain on urination when the adhesion resolves, which may be misinterpreted as a urinary infection. Treatment is either pharmacological or surgical. Pharmacological treatment consists of oestrogen cream or glucocorticoid cream. Surgical treatment involves techniques such as manual separation, or the use of a double-end probe or tenaculum following anaesthesia with Emla cream. Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. In girls without symptoms, reasons for opening the adhesion may include the parents’ wish for the genitalia to appear normal or for the child to avoid subsequent dysuria in connection with soreness when the adhesion opens. If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. However, it is important to choose a method with acceptable side effects, and to ensure that opening of the adhesion does not damage the epithelium, leading to a risk of re-adhesion. Our evaluation of patient records from St. Olavs Hospital revealed that, in more than half of cases, complete opening was not achieved with pharmacological therapy, surgery or a combination of the two. There is no clear-cut effective treatment for labial adhesion, and there is no reason to treat girls in the absence of symptoms. The condition resolves spontaneously in all, at puberty if not before.

• #47 Labial Adhesions | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/labial-adhesion/

  If a patient has no symptoms, medical treatment may not be necessary, and the adhesion may resolve on its own with time. […] In cases where the adhesion is covering the vagina or causing symptoms, your child’s doctor can use an estrogen-based cream or steroid cream, which can help to separate the tissue. […] We only recommend surgical separation in rare cases, when the adhesion is very thick and topical treatment has failed. […] Our board-certified pediatric and adolescent gynecologists have specialized training in the reproductive health concerns of girls of all ages. We understand that labial adhesions can be stressful. We will put families and patients at ease by carefully explaining the medical condition, discussing the various options for treatment, and supporting your family with follow-up visits and consultation with our colleagues in other specialties as needed.

• #48 Labial adhesion – diagnostics and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2017/01/original-article/labial-adhesion-diagnostics-and-treatment

  Labial adhesion is relatively common, but the condition is little known among doctors and parents. The article assesses treatment in the specialist health service. Treatment for labial adhesion had a limited effect in this study. As the literature suggests that the condition results in few symptoms and resolves spontaneously in virtually all girls in puberty, no compelling medical reason exists for opening the adhesion in asymptomatic girls. It is important that doctors are aware of the condition in order to prevent misdiagnosis and to provide parents with adequate information. For parents it is important to know that spontaneous resolution may result in soreness and dysuria. Knowledge of the condition can most likely prevent unnecessary worry. The vast majority of girls with labial adhesion are asymptomatic, and this is the case irrespective of age. However, the condition may be associated with various symptoms, for example a stinging pain on urination when the adhesion resolves, which may be misinterpreted as a urinary infection. Treatment is either pharmacological or surgical. Pharmacological treatment consists of oestrogen cream or glucocorticoid cream. Surgical treatment involves techniques such as manual separation, or the use of a double-end probe or tenaculum following anaesthesia with Emla cream. Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. In girls without symptoms, reasons for opening the adhesion may include the parents’ wish for the genitalia to appear normal or for the child to avoid subsequent dysuria in connection with soreness when the adhesion opens. If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. However, it is important to choose a method with acceptable side effects, and to ensure that opening of the adhesion does not damage the epithelium, leading to a risk of re-adhesion. Our evaluation of patient records from St. Olavs Hospital revealed that, in more than half of cases, complete opening was not achieved with pharmacological therapy, surgery or a combination of the two. There is no clear-cut effective treatment for labial adhesion, and there is no reason to treat girls in the absence of symptoms. The condition resolves spontaneously in all, at puberty if not before.

• #49

  https://journals.lww.com/jomh/fulltext/2024/15030/labial_fusion_in_a_postmenopausal_woman_presenting.16.aspx

  Genitourinary syndrome of menopause refers to the collection of signs and symptoms associated with decrease in estrogen and other sex steroids involving changes in labia majora/minora, clitoris, vestibule/introitus, vagina, urethra, and bladder. […] Labial fusion refers to the complete or partial fusion of labia minora in the midline due to adhesions. […] In the postmenopausal stage, low estrogen levels render the genital area more prone to irritation and inflammation leading to labial fusion. […] Management protocol at the early stage includes topical estrogen therapy and treatment of predisposing factors, whereas refractory cases need surgical separation. […] Complete labial fusion is a rare presentation of GSM. Patient embarrassment is one of the major reasons behind it remaining undiagnosed and untreated.

• #50 An Unusual Cause of Urinary Pseudoincontinence: Two Rare Cases of Labial Fusion in Adolescent and Postmenopausal Women

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/21668/JPJ/fullText

  Labial adhesions are usually a pediatric condition and are asymptomatic. They can also occur in postmenopausal age group albeit uncommon due to hypoestrogenism causing senile vaginitis. Here, we have two cases of labial fusion in different age groups, 17-years-old and 65-year-old females presenting with urinary symptoms. […] Labial fusion is defined as the partial or complete fusion of the labia minora causing partial or complete occlusion of the vaginal and/or urethral opening. It can be congenital or acquired. […] Estrogen deficiency plays a major role in the development of labial adhesion, thereby explaining its high incidence rate in the prepubertal females and it is the cause in the postmenopausal age. It can present with vulvar symptoms such as burning, itching, pain, dyspareunia, and discomfort during menstruation, vaginal discharge, recurrent urinary tract infections, and dribbling of urine. […] Although uncommon, labial fusion can occur in the postpubertal females, one needs to have high index of suspicion to diagnose this rare condition as the patient often presents with common gynecological symptoms of difficult menstruation and urinary dribbling.

• #51 Labial Fusion (Adhesion on Genital Lips)

  https://www.eserdag.com/en/labial-fusion-adhesion-on-genital-lips

  There are two periods in which labial fusions are most common: infancy/childhood, called the „prepubertal” period, and the postmenopausal period. […] The main reason for labial fusion that occurs during menopause is hypoestrogenism, that is, the low estrogen level that occurs with menopause. […] Among the labial fusion symptoms that occur during menopause; inability to urinate, frequent urinary tract infections, post-void dribbling, frequent vaginal infection, inability to have sexual intercourse, painful sexual intercourse (dyspareunia). […] Labial synechiae are frequently associated with chronic and inflammatory diseases of the genital area, especially in the adult age group. […] There are different opinions about labial fusion treatment in infancy and childhood. […] Among the most commonly used methods in the treatment of labial fusion in childhood; opening the lips manually by pulling with hand, estrogen cream treatments.

• #52 Labial adhesions in adult women. Labial fusion

  https://dermnetnz.org/topics/labial-adhesion-adult-women

  Labial adhesion means that the labia minora are stuck together or fused. Adhesion rarely results in complete labial fusion; more often it is partial. […] Secondary labial adhesion usually occurs after menopause. Labial adhesion in prepubertal girls is often present since birth and is known as primary labial adhesion. […] The most common causes of labial adhesion in adult women are listed below. […] Labial adhesion joining the left and right labia minora results in a narrowed vaginal opening (the vaginal introitus). […] Symptoms may be absent or the adhesion may lead to: Painful sex (dyspareunia). […] Partial labial adhesion may be unobserved but often, symptoms and complications arise. […] Complete labial fusion means that urine and vaginal fluids including menstrual blood build up behind the fused labia; this is an emergency and urgent medical assistance should be sought. […] Treatment depends on the cause of the fusion. It does not always require specific treatment.

• #53 Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report

  https://www.wjgnet.com/2307-8960/full/v10/i35/12990.htm

  Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report […] Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams, and surgical treatment should be considered. […] Labial adhesions are difficult to detect in elderly women because they are typically not sexually active. […] The main complaint is urinary disorders, and since urinary tract infections and urinary disorders are very common in the elderly, adhesions in the vulva may not be detected. […] However, urinary tract infections and urethral stenosis caused by labial adhesions can also occur, so it is important to be aware of this. […] In the present case, since the labial adhesion did not improve after 2 wk of topical estrogen cream and antibiotics, surgical correction was performed.

• #54 Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report

  https://www.wjgnet.com/2307-8960/full/v10/i35/12990.htm

  One month after the surgery, the discomfort while urinating was not present, and the adhesion did not recur. […] Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams, and surgical treatment is likely to be considered. […] In addition, it requires plastic surgery aimed at preventing recurrence and reconstruction.

• #55 Labial Agglutination in a Reproductive Age Woman

  https://clinmedjournals.org/articles/ogcr/obstetrics-and-gynaecology-cases-reviews-ogcr-9-231.php?jid=ogcr

  A 25-year-old nulligravid was consulted due to inability to have sexual intercourse accompanied by chronic urinary hesitancy, dribbling, and dysmenorrhea. On gynecologic pelvic examination, she presented with complete, adult-onset fusion of the labia minora. […] This paper describes a stepwise management of a reproductive-age woman with complete labial fusion. Treatment goals include etiological determination, anatomic correction, restoration of normal sexual function, improvement of genitourinary function, and improved quality of life. […] Labial fusion during reproductive years should be carefully investigated as this is exceedingly rare and unexpected in reproductive-age women with normal hypothalamic pituitary ovarian (HPO) function. Issues of underlying predisposing factors need to be addressed and are necessary to prevent recurrence.

• #56 Labial Agglutination in a Reproductive Age Woman

  https://clinmedjournals.org/articles/ogcr/obstetrics-and-gynaecology-cases-reviews-ogcr-9-231.php?jid=ogcr

  There are different treatments for labial adhesions in pre-pubertal and postmenopausal women. It can be managed conservatively through topical estrogen treatment with or without manual separation of labia or surgery. However, in reproductive-age women with normal HPO function, surgery is the logical treatment choice. […] A combination of topical antibiotics, estrogen, and emollients were helpful in reducing recurrence of adhesions. Improvement was noticeable on subsequent follow-ups. The result was similar to other studies. […] The patient’s fertility, sexual function, and quality of life were markedly improved, and she conceived 6 months after the surgery.

• #57 Labial Agglutination in a Reproductive Age Woman

  https://clinmedjournals.org/articles/ogcr/obstetrics-and-gynaecology-cases-reviews-ogcr-9-231.php?jid=ogcr

  There are different treatments for labial adhesions in pre-pubertal and postmenopausal women. It can be managed conservatively through topical estrogen treatment with or without manual separation of labia or surgery. However, in reproductive-age women with normal HPO function, surgery is the logical treatment choice. […] A combination of topical antibiotics, estrogen, and emollients were helpful in reducing recurrence of adhesions. Improvement was noticeable on subsequent follow-ups. The result was similar to other studies. […] The patient’s fertility, sexual function, and quality of life were markedly improved, and she conceived 6 months after the surgery.

• #58 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  Labial adhesion, or labial fusion, is a condition where the inner lips of the vulva, known as the labia minora, stick together. […] Labial adhesions, especially in adult women, can have a significant negative impact on a person’s sexual health and well-being. Serious emotional and physical difficulties may result from the fusion of the labia minora, which may affect intimacy and general quality of life. […] One of the most prevalent and distressing effects of labial adhesions is the sensation of discomfort during sexual activity. […] Labial adhesions can cause severe reductions in both sexual pleasure and satisfaction in addition to physical pain. […] Labial adhesions have an effect on a person’s emotions and psychological well-being in addition to their physical side. […] It is critical to understand that labial adhesions have significant emotional and psychological repercussions that should not be overlooked.

• #59 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  The treatment of labial adhesions depends on the severity of the symptoms and the underlying cause. […] Labial adhesions are frequently treated with topical estrogen creams, especially when there is an estrogen deficit involved. […] Labial adhesions can be prevented from recurring by practicing proper hygiene and avoiding irritants. […] Adults with labial adhesions may find it stressful and difficult to manage, especially in terms of intimacy and sexual health. […] People can effectively handle labial adhesions and overcome the associated challenges, particularly those linked to sexual intercourse, by collaborating closely with healthcare specialists and investigating different therapy techniques.

• #60 56441 CPT4 – GenHealth.ai

  https://genhealth.ai/code/cpt4/56441-lysis-of-labial-adhesions

  Lysis of labial adhesions is a minor surgical procedure to separate fused labia minora (the inner lips of the vulva) typically seen in young girls. The procedure helps restore the normal anatomy of the vulva and prevent associated problems. […] Lysis of labial adhesions addresses the condition where the labia minora stick together, causing difficulty with urination, discomfort, or recurrent infections. The goal is to separate the labia, relieving symptoms and preventing future complications. […] Nursing staff for assistance and comfort measures. […] During the procedure, the child might feel minimal discomfort due to the numbing effect of the local anesthesia. After the procedure, there may be slight soreness or sensitivity, which can usually be relieved with topical ointments or mild pain relievers. Parents are provided with comfort measures and clear instructions to ensure a smooth recovery.

• #61 Labial Adhesions | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/labial-adhesion/

  If a patient has no symptoms, medical treatment may not be necessary, and the adhesion may resolve on its own with time. […] In cases where the adhesion is covering the vagina or causing symptoms, your child’s doctor can use an estrogen-based cream or steroid cream, which can help to separate the tissue. […] We only recommend surgical separation in rare cases, when the adhesion is very thick and topical treatment has failed. […] Our board-certified pediatric and adolescent gynecologists have specialized training in the reproductive health concerns of girls of all ages. We understand that labial adhesions can be stressful. We will put families and patients at ease by carefully explaining the medical condition, discussing the various options for treatment, and supporting your family with follow-up visits and consultation with our colleagues in other specialties as needed.

• #62 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470461/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. It also may be known as synechia vulvae or labial agglutination. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. Therefore, these patients are typically managed with estrogen cream when symptomatic. […] Labial adhesions are managed by an interprofessional team that includes the pediatrician, nurse practitioner, and primary care provider. The diagnosis is made on a clinical examination and the treatment depends on symptoms. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. One of the major indications for treatment is a urinary tract infection. Some studies have demonstrated a success rate of up to 90% with the use of topical estrogen cream. In rare cases, surgical release of the adhesions may be required. […] Recurrences are common with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty. Some studies report a rate of recurrence from 11% to 14% with either topical or surgical management.

• #63 56441 CPT4 – GenHealth.ai

  https://genhealth.ai/code/cpt4/56441-lysis-of-labial-adhesions

  Lysis of labial adhesions is a minor surgical procedure to separate fused labia minora (the inner lips of the vulva) typically seen in young girls. The procedure helps restore the normal anatomy of the vulva and prevent associated problems. […] Lysis of labial adhesions addresses the condition where the labia minora stick together, causing difficulty with urination, discomfort, or recurrent infections. The goal is to separate the labia, relieving symptoms and preventing future complications. […] Nursing staff for assistance and comfort measures. […] During the procedure, the child might feel minimal discomfort due to the numbing effect of the local anesthesia. After the procedure, there may be slight soreness or sensitivity, which can usually be relieved with topical ointments or mild pain relievers. Parents are provided with comfort measures and clear instructions to ensure a smooth recovery.

• #64 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  Labial adhesion, or labial fusion, is a condition where the inner lips of the vulva, known as the labia minora, stick together. […] Labial adhesions, especially in adult women, can have a significant negative impact on a person’s sexual health and well-being. Serious emotional and physical difficulties may result from the fusion of the labia minora, which may affect intimacy and general quality of life. […] One of the most prevalent and distressing effects of labial adhesions is the sensation of discomfort during sexual activity. […] Labial adhesions can cause severe reductions in both sexual pleasure and satisfaction in addition to physical pain. […] Labial adhesions have an effect on a person’s emotions and psychological well-being in addition to their physical side. […] It is critical to understand that labial adhesions have significant emotional and psychological repercussions that should not be overlooked.

• #65 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  The treatment of labial adhesions depends on the severity of the symptoms and the underlying cause. […] Labial adhesions are frequently treated with topical estrogen creams, especially when there is an estrogen deficit involved. […] Labial adhesions can be prevented from recurring by practicing proper hygiene and avoiding irritants. […] Adults with labial adhesions may find it stressful and difficult to manage, especially in terms of intimacy and sexual health. […] People can effectively handle labial adhesions and overcome the associated challenges, particularly those linked to sexual intercourse, by collaborating closely with healthcare specialists and investigating different therapy techniques.

• #66 Labial fusion

  https://www.nhs.uk/conditions/labial-fusion/

  Labial fusion, or labial adhesion, is when the small inner lips around the entrance to the vagina become sealed together. […] For most babies or girls, labial fusion does not cause any problems and is often discovered accidentally by a parent or carer during nappy changing or bathing. […] Treatment for labial fusion is not recommended unless there are other symptoms, such as dribbling after peeing, which may cause problems or discomfort. […] Surgery is very rarely needed to treat labial fusion. […] Labial fusion is not linked to any medical condition and has no long-term implications for your child. […] It will not affect her future fertility or sexual life. In most cases, a fusion corrects itself during puberty.

• #67 Labial Adhesions (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/labial-adhesions.html

  Labial adhesions happen when the labia minora (the inner folds of skin surrounding the vaginal opening) become fused together. […] Labial adhesions will go away on their own during puberty if not well before that. They only need medical treatment if a large part of the labia is fused or the adhesions cause problems (such as trouble peeing or infections). […] To prevent the labia from growing back together after the adhesions part, put white petroleum jelly on the area twice a day for 612 months. After your child finishes puberty, the labial adhesions aren’t likely to come back. […] Labial adhesions do not cause any lasting problems. Later in life, they wont affect your childs sexuality or fertility (ability to have children).

• #68 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  The treatment of labial adhesions depends on the severity of the symptoms and the underlying cause. […] Labial adhesions are frequently treated with topical estrogen creams, especially when there is an estrogen deficit involved. […] Labial adhesions can be prevented from recurring by practicing proper hygiene and avoiding irritants. […] Adults with labial adhesions may find it stressful and difficult to manage, especially in terms of intimacy and sexual health. […] People can effectively handle labial adhesions and overcome the associated challenges, particularly those linked to sexual intercourse, by collaborating closely with healthcare specialists and investigating different therapy techniques.

• #69 Labial Adhesion: Causes, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/16435-labial-adhesions

  Labial adhesions have other names, which may be more informal or medical. These names include: […] Labial fusion. […] If your child has a labial adhesion, a healthcare provider may suggest a wait and see approach if they dont have any symptoms or problems peeing. […] If you or your child has symptoms, labial adhesion treatment may include: […] Topical treatments […] Manual or surgical separation […] Providers only surgically separate a labial adhesion if you cant pee and other treatments dont work. […] The outlook for labial adhesions is good. They often go away without treatment once your child begins menstruating. […] And remember, although rare, labial adhesions can also affect adults, especially during times in which their bodies dont produce as much estrogen.

• #70 What Is a Labial Fusion?

  https://www.webmd.com/children/what-is-a-labial-fusion

  Labial fusions are not linked to other medical conditions and have not proven to have long-term effects on those who recover. A labial fusion may recur, but the issue is often resolved once a child reaches puberty, and it can be easily prevented in the case of adults. […] Additionally, labial fusions are rare. They are usually not a cause for concern, as they often resolve on their own and can be both easily prevented and treated.

• #71 Labial fusion

  https://www.nhs.uk/conditions/labial-fusion/

  Labial fusion, or labial adhesion, is when the small inner lips around the entrance to the vagina become sealed together. […] For most babies or girls, labial fusion does not cause any problems and is often discovered accidentally by a parent or carer during nappy changing or bathing. […] Treatment for labial fusion is not recommended unless there are other symptoms, such as dribbling after peeing, which may cause problems or discomfort. […] Surgery is very rarely needed to treat labial fusion. […] Labial fusion is not linked to any medical condition and has no long-term implications for your child. […] It will not affect her future fertility or sexual life. In most cases, a fusion corrects itself during puberty.

• #72 Labial Adhesions (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/labial-adhesions.html

  Labial adhesions happen when the labia minora (the inner folds of skin surrounding the vaginal opening) become fused together. […] Labial adhesions will go away on their own during puberty if not well before that. They only need medical treatment if a large part of the labia is fused or the adhesions cause problems (such as trouble peeing or infections). […] To prevent the labia from growing back together after the adhesions part, put white petroleum jelly on the area twice a day for 612 months. After your child finishes puberty, the labial adhesions aren’t likely to come back. […] Labial adhesions do not cause any lasting problems. Later in life, they wont affect your childs sexuality or fertility (ability to have children).

• #73 Labial Fusion In Children | KidsHealth New Zealand’s Trusted Voice On Children’s Health

  https://www.kidshealth.org.nz/vulval-conditions/labial-fusion-in-children

  Labial fusion is common in tamariki (children). In most cases, it resolves as your child gets older and requires no treatment. […] Labial fusion is common in tamariki. […] Labial fusion resolves as your child grows. […] In most cases, labial fusion needs no treatment. […] Treatment is not needed for most cases of labial fusion in children. […] By the time your child reaches puberty, the join has usually separated naturally. […] Leaving labial fusion alone is the safest way to manage it. […] Treatment may be required if the labial fusion is causing problems. […] Labial fusion is not linked to any other medical conditions. […] It will not impact on your child’s ability to have children in the future.

• #74 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470461/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. It also may be known as synechia vulvae or labial agglutination. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. Therefore, these patients are typically managed with estrogen cream when symptomatic. […] Labial adhesions are managed by an interprofessional team that includes the pediatrician, nurse practitioner, and primary care provider. The diagnosis is made on a clinical examination and the treatment depends on symptoms. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. One of the major indications for treatment is a urinary tract infection. Some studies have demonstrated a success rate of up to 90% with the use of topical estrogen cream. In rare cases, surgical release of the adhesions may be required. […] Recurrences are common with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty. Some studies report a rate of recurrence from 11% to 14% with either topical or surgical management.

• #75 Labial Adhesions – Kidshealth | Akron Children’s

  https://www.akronchildrens.org/kidshealth/en/parents/labial-adhesions.html

  Also called: Labial Fusion, Labial Agglutination, Synechia Vulvae […] Labial adhesions happen when the labia minora (the inner folds of skin surrounding the vaginal opening) become fused together. In most cases, only a small part of the labia is fused, so the adhesions usually dont cause any problems. […] Labial adhesions will go away on their own during puberty if not well before that. They only need medical treatment if a large part of the labia is fused or the adhesions cause problems (such as trouble peeing or infections). […] If treatment is needed, doctors prescribe an estrogen or steroid cream to help the adhesions come apart. […] To prevent the labia from growing back together after the adhesions part, put white petroleum jelly on the area twice a day for 612 months. After your child finishes puberty, the labial adhesions aren’t likely to come back. […] Because irritation to the labia can make the adhesions worse or cause them to come back: Keep the genital area clean […] Labial adhesions do not cause any lasting problems. Later in life, they wont affect your childs sexuality or fertility (ability to have children).

• #76 Nearly-complete labial adhesions diagnosed with repetitive cystitis in postmenopausal women: A case report

  https://www.wjgnet.com/2307-8960/full/v10/i35/12990.htm

  One month after the surgery, the discomfort while urinating was not present, and the adhesion did not recur. […] Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams, and surgical treatment is likely to be considered. […] In addition, it requires plastic surgery aimed at preventing recurrence and reconstruction.

• #77 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK470461/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. It also may be known as synechia vulvae or labial agglutination. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. Therefore, these patients are typically managed with estrogen cream when symptomatic. […] Labial adhesions are managed by an interprofessional team that includes the pediatrician, nurse practitioner, and primary care provider. The diagnosis is made on a clinical examination and the treatment depends on symptoms. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. One of the major indications for treatment is a urinary tract infection. Some studies have demonstrated a success rate of up to 90% with the use of topical estrogen cream. In rare cases, surgical release of the adhesions may be required. […] Recurrences are common with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty. Some studies report a rate of recurrence from 11% to 14% with either topical or surgical management.

• #78 Labial Adhesions | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/23971

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. […] The exact cause of labial fusion remains unknown. However, it is believed to occur in a low estrogen state. […] Management for these patients tends to consist of lysis of the adhesion as well as applying topical estrogen cream. […] For those who do develop labial adhesions during the reproductive age, there is usually a history of some sort of genital trauma or irritation to the genitalia. […] Management remains the same. For preventive measures, it is recommended for minimization of vulvar irritation accompanied by adequate hygiene to the perineal area. […] Labial adhesions are managed by an interprofessional team that includes the pediatrician, nurse practitioner, and primary care provider.

• #79 Labial Adhesions | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/23971

  If the patient is clinically asymptomatic, there is no need for treatment and reassurance can be provided to the family as well as education on proper hygiene. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. […] Recurrences are common with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty.

• #80 Labial adhesion – diagnostics and treatment | Tidsskrift for Den norske legeforening

  https://tidsskriftet.no/en/2017/01/original-article/labial-adhesion-diagnostics-and-treatment

  Labial adhesion is relatively common, but the condition is little known among doctors and parents. The article assesses treatment in the specialist health service. Treatment for labial adhesion had a limited effect in this study. As the literature suggests that the condition results in few symptoms and resolves spontaneously in virtually all girls in puberty, no compelling medical reason exists for opening the adhesion in asymptomatic girls. It is important that doctors are aware of the condition in order to prevent misdiagnosis and to provide parents with adequate information. For parents it is important to know that spontaneous resolution may result in soreness and dysuria. Knowledge of the condition can most likely prevent unnecessary worry. The vast majority of girls with labial adhesion are asymptomatic, and this is the case irrespective of age. However, the condition may be associated with various symptoms, for example a stinging pain on urination when the adhesion resolves, which may be misinterpreted as a urinary infection. Treatment is either pharmacological or surgical. Pharmacological treatment consists of oestrogen cream or glucocorticoid cream. Surgical treatment involves techniques such as manual separation, or the use of a double-end probe or tenaculum following anaesthesia with Emla cream. Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. In girls without symptoms, reasons for opening the adhesion may include the parents’ wish for the genitalia to appear normal or for the child to avoid subsequent dysuria in connection with soreness when the adhesion opens. If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. However, it is important to choose a method with acceptable side effects, and to ensure that opening of the adhesion does not damage the epithelium, leading to a risk of re-adhesion. Our evaluation of patient records from St. Olavs Hospital revealed that, in more than half of cases, complete opening was not achieved with pharmacological therapy, surgery or a combination of the two. There is no clear-cut effective treatment for labial adhesion, and there is no reason to treat girls in the absence of symptoms. The condition resolves spontaneously in all, at puberty if not before.

• #81 Labial Adhesions | Children’s Hospital Colorado

  https://www.childrenscolorado.org/conditions-and-advice/conditions-and-symptoms/conditions/labial-adhesion/

  If a patient has no symptoms, medical treatment may not be necessary, and the adhesion may resolve on its own with time. […] In cases where the adhesion is covering the vagina or causing symptoms, your child’s doctor can use an estrogen-based cream or steroid cream, which can help to separate the tissue. […] We only recommend surgical separation in rare cases, when the adhesion is very thick and topical treatment has failed. […] Our board-certified pediatric and adolescent gynecologists have specialized training in the reproductive health concerns of girls of all ages. We understand that labial adhesions can be stressful. We will put families and patients at ease by carefully explaining the medical condition, discussing the various options for treatment, and supporting your family with follow-up visits and consultation with our colleagues in other specialties as needed.

• #82 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  Labial adhesion, or labial fusion, is a condition where the inner lips of the vulva, known as the labia minora, stick together. […] Labial adhesions, especially in adult women, can have a significant negative impact on a person’s sexual health and well-being. Serious emotional and physical difficulties may result from the fusion of the labia minora, which may affect intimacy and general quality of life. […] One of the most prevalent and distressing effects of labial adhesions is the sensation of discomfort during sexual activity. […] Labial adhesions can cause severe reductions in both sexual pleasure and satisfaction in addition to physical pain. […] Labial adhesions have an effect on a person’s emotions and psychological well-being in addition to their physical side. […] It is critical to understand that labial adhesions have significant emotional and psychological repercussions that should not be overlooked.

• #83 How Do Labial Adhesions Impact Sexual Health and Intimacy?

  https://www.icliniq.com/articles/sexual-health/the-impact-of-labial-adhesions-on-sexual-health-and-intimacy

  The treatment of labial adhesions depends on the severity of the symptoms and the underlying cause. […] Labial adhesions are frequently treated with topical estrogen creams, especially when there is an estrogen deficit involved. […] Labial adhesions can be prevented from recurring by practicing proper hygiene and avoiding irritants. […] Adults with labial adhesions may find it stressful and difficult to manage, especially in terms of intimacy and sexual health. […] People can effectively handle labial adhesions and overcome the associated challenges, particularly those linked to sexual intercourse, by collaborating closely with healthcare specialists and investigating different therapy techniques.

• #84

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=zx4356

  The labia are the small lips around the opening of the vagina and urethra. Labial adhesion means that those lips have joined together instead of staying apart. […] This is common in girls, especially those younger than 6 years. It often causes no symptoms and will go away by itself. But it may cause symptoms such as pain or urinary problems. If so, you can treat it with a prescription cream. […] Follow-up care is a key part of your child’s treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line if your child is having problems. […] Don’t try to separate the labia yourself. […] If your doctor has prescribed a prescription cream, follow the doctor’s directions about how often to apply it and how long to use it. […] Call your doctor or nurse advice line now or seek immediate medical care if your child has symptoms of a urinary infection, such as: Blood or pus in the urine. […] Watch closely for changes in your child’s health, and be sure to contact your doctor or nurse advice line if there is no change in the adhesion after several weeks.

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