Materiały źródłowe

• #1 Labial Adhesions

  https://ej-med.org/index.php/ejmed/article/view/1917

  Labial adhesion is characterized by partial or complete fusion of labia minora or labia majora. […] The incidence of labial adhesions is about 0.61.4% in children, but the incidence in elderly is unknown, and only a few case reports are documented in postmenopausal women. […] The exact cause of labial fusion remains unknown but It occurs mostly due to estrogen deficiency both in prepubertal girls and menopausal women, and is commonly associated with lack of sexual activity and inflammatory skin disorder. […] Labial adhesion in menopausal women is usually triad of estrogen deficiency, inflammatory skin disorders, lack of sexual activity.

• #2 Labial fusion – Wikipedia

  https://en.wikipedia.org/wiki/Labial_fusion

  Labial fusion is not uncommon in infants and young girls. It is most common in infants between the ages of 13 and 23 months, and has an incidence of 3.3% in this age group. It is estimated that labial fusion occurs in 1.8% of all prepubertal girls. It is rare in adult women, particularly in reproductive age, but is occasionally found in postpartum and postmenopausal women.

• #3 Labial Fusion in Childhood: Management and Treatment Strategies – Bezmialem Science

  https://www.bezmialemscience.org/articles/labial-fusion-in-childhood-management-and-treatment-strategies/doi/bas.galenos.2024.25349

  Labial fusion (LF) is frequently an asymptomatic condition and hypoestrogenism plays an important role in the pathopysiology. […] The incidence of LF in girls in childhood is stated as 0.6-5% in different sources. […] According to an epidemiological study conducted in the USA, the age distribution in which it is observed is given as 6-24 months. […] The risk of recurrence decreases with increasing age and increased endogenous estrogen production. Factors contributing to recurrence include poor genital hygiene, recurrent vulvovaginitis, and vulvar dermatoses.

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

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

  It is estimated in the literature as a whole that labial adhesion occurs in 0.6 to 3.3 % of girls of prepubertal age. […] Although most children with labial adhesion are asymptomatic, the condition has been associated with a number of complaints, such as urethritis, itching, vaginitis, altered urinary flow, asymptomatic bacteriuria, urinary tract infection, urinary retention, split urinary stream, post-void dribble as a result of accumulation of urine in the adhesion, and enuresis. […] 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. […] 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.

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

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

  Labial adhesions 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. […] A prospective study of more than 1900 girls assessed through a pediatric outpatient clinic reported a 1.8% incidence of labial adhesions, whereas a review of more than 9000 female infants found no cases of neonatal labial adhesions. The incidence of labial adhesions worldwide is unknown but presumably is similar to the US incidence. […] Labial adhesions are, by definition, a disorder of females and occur most often in infants and girls aged 3 months to 6 years, with a peak incidence around the age of 13-23 months. They have not been reported in the newborn period. If left untreated, labial adhesions usually spontaneously resolve at puberty as a consequence of increased estrogen levels. They also occur in older women, albeit rarely. […] No strong evidence supports a racial predilection.

• #6 Labial Agglutination in a Prepubertal Girl: Effect of Topical Oestrogen | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0586

  Labial agglutination in younger prepubertal girls is rather common, but it is rarely described in dermatological textbooks. […] The estimated labial adhesion rate in girls is about 1.8%, with a peak incidence of 3.3% at 1323 months of age. […] However, in a single study systematically studying genital findings in prepubertal girls, a prevalence as great as 38.9% has been found, including very small adhesions of 2 mm or less detected only through the colposcope. […] The cause of labial agglutination appears to a mild inflammatory condition in a child with a thin layer of labial epithelial cells secondary to a low oestrogen level. […] If the labial agglutination is asymptomatic it is recommended to wait for spontaneous resolution, which will often happen when the oestrogen level rises at the onset of puberty.

• #7 Labial fusion

  https://www.rch.org.au/kidsinfo/fact_sheets/Labial_fusion/?hc_location=ufi

  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. […] The exact cause of labial fusion is not known, but sometimes it occurs after an inflammation of the labial area (e.g. after a simple infection such as vulvovaginitis, or after mild trauma to the area). […] 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.

• #8 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, labial fusion needs no treatment. […] Labial fusion resolves as your child grows. […] Labial fusion usually develops when a child is around 1 to 2 years of age. […] Treatment is not needed for most cases of labial fusion in children. […] Labial fusion is not linked to any other medical conditions.

• #9 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. […] 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. […] Labial agglutination is extremely rare in reproductive-age women.

• #10 Labial Agglutination in a Reproductive Age Woman

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

  Labial adhesion in reproductive age is unexpected and extremely rare due to adequate levels of estrogen. Therefore, in the reproductive-age group, the integrity of their HPO axis should be evaluated. […] Recurrent urinary tract infection is more commonly a result, rather than a cause of labial adhesions. However, the temporality of events and the patient’s lack of any other predisposing factors point to an association with her urinary symptoms. […] 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. […] 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.

• #11

  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. […] Approximately 40%54% of women experience a genitourinary syndrome of menopause (GSM), which is often undiagnosed/not treated. […] In the postmenopausal stage, low estrogen levels render the genital area more prone to irritation and inflammation leading to labial fusion. […] Complete labial fusion is a rare presentation of GSM. […] Management protocol at the early stage includes topical estrogen therapy and treatment of predisposing factors, whereas refractory cases need surgical separation.

• #12 An unusual clinical presentation of labial fusion in post pubertal period – Document – Gale OneFile: Health and Medicine

  https://go.gale.com/ps/i.do?id=GALE%7CA536389218&sid=googleScholar&v=2.1&it=r&linkaccess=abs&issn=23201770&p=HRCA&sw=w

  Labial fusion is sealing of labia minora in midline, also known as labial adhesion or labial agglutination or synechia vulvae. This condition is common in pre-pubertal females usually asymptomatic when oestrogen levels are low and commonly resolves spontaneously post-puberty if unresolved medical treatment includes use of estrogen cream or betamethasone cream application, very rarely surgical treatment required, if not responding to medical treatment due to dense adhesions. […] This case report is unusual as it has presented in a post- pubertal female requiring surgical management.

• #13 Bladder Outlet Obstruction Due to Recurrent Complete Labial Fusion in Postmenopausal Woman—Case Report

  https://www.mdpi.com/2075-4418/14/23/2659?type=check_update&version=2

  Labial fusion is a rare condition typically observed in prepubescent girls, but it can also occur in postmenopausal women due to estrogen deficiency. […] The incidence of labial adhesions in children is approximately 0.6–1.4%, while the incidence in the elderly population remains unclear. […] In postmenopausal women, these adhesions may also affect the labia majora. […] The precise cause of labial adhesion is not fully understood. […] In acquired cases, the potential underlying factors include estrogen deficiency, injuries, Behçet’s disease, Stevens–Johnson syndrome, mucous membrane pemphigoid, and graft-versus-host disease. […] In our patient, there was no history of vulvar lesions, repeated infections, chronic inflammatory conditions, or local trauma but only atrophy. […] Surgical intervention remains the primary treatment option for complete labial fusion in postmenopausal women, particularly in cases involving bladder outlet obstruction or significant urinary symptoms.

• #14 Labial Adhesions – StatPearls – NCBI Bookshelf

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

  Labial adhesion may affect up to 2% of prepubertal girls, with the typical age of presentation for labial adhesions at two years of age. […] The exact cause of labial fusion remains unknown. However, it is believed to occur in a low estrogen state. […] The condition is believed to be due to inflammation of the labia in a low-estrogen environment. […] Some studies report a rate of recurrence from 11% to 14% with either topical or surgical management.

• #15 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. […] 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. […] Labial fusion is often an acquired condition typically seen in prepubertal girls, usually below 6 years of age. It is uncommonly seen in postmenopausal woman and even more rarely in the reproduction age group. […] 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. […] 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.

• #16 Labial Fusion (Adhesion on Genital Lips)

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

  Labial fusion is the condition of the inner genital lips (labia minora) sticking together, also known as „labial adhesion” or „labial synechiae”. […] The incidence of labial fusion in infants is between 0.6-3%. […] 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. […] 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. […] Labial synechiae are frequently associated with chronic and inflammatory diseases of the genital area, especially in the adult age group. […] Early diagnosis and treatment of patients with labial fusion and genital adhesions are important.

• #17 :: JMM :: Journal of Menopausal Medicine

  https://e-jmm.org/DOIx.php?id=10.6118/jmm.22020

  Labial adhesions in postmenopausal women are caused by various inflammatory processes in the context of estrogen deficiency. […] Early diagnosis and treatment of LS can prevent disease progression, leading to labial adhesions and malignancy. […] Labial adhesion is defined as the partial or complete fusion of the labia minora or majora that has an incidence of 2% among prepuberal females. […] Among dermatologic conditions associated with labial adhesion are lichen sclerosus (LS) and lichen planus. […] The above case shows a striking clinical presentation of vulvar HHD that masked the diagnosis of LS and led to development of labial adhesion. […] Treatment for mild cases of labial adhesion includes treating the underlying condition together with TCS and topical estrogen creams. […] Recurrence of adhesions has been reported in 14%20% of patients who have undergone surgical or manual separation; thus it is important to emphasize topical estrogen application and regular digital separation of the vulva, especially in patients who are not sexually active. […] Prevention of chronic complications of LS such as labial adhesion may improve the quality of life of patients affected by this condition.

• #18 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. […] Labial adhesion is relatively common, and in the literature it is estimated to occur in 0.6-3.3 % of prepubertal girls. Doctors should therefore be aware of the condition, which is also referred to in the Norwegian Electronic Medical Handbook. […] 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. […] In this review of patient records, just over half of patients for whom the outcome is known achieved complete opening of the vagina after treatment with topical oestrogen or surgery.

• #19 Labial fusion – GPnotebook

  https://gpnotebook.com/en-GB/pages/obstetrics/labial-fusion

  labial fusion/labial adhesions may be defined as the partial or complete adherence of the apposing vulval labia minora […] most frequently seen in infants and very young children […] labial adhesions and fusion in children in the absence of any other pathology is well documented […] many cases are discovered incidentally during routine examination […] only extremely rarely been noted to be present at birth – most authors regard it as an acquired condition […] „physiological” fusion is postulated to arise in infants and young children with endogenously low estrogen levels who may or may not have an associated inflammatory condition such as vulvovaginitis […] Leung et al found that labial fusion was most frequently seen in infants and young children, with a peak incidence of 3.3% in children ages 13 to 23 months

• #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. […] 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. […] Labial adhesions can impact as much as 2% of girls before puberty. […] Labial adhesions do not typically require any special tests for diagnosis. The condition is diagnosed based on a doctor’s clinical examination and evaluation, which includes gathering information from symptoms, medical history, and physical examination. However, if treatment is needed, the doctor may recommend the following tests: – Urinalysis: This test may be done to check for urinary tract infections, which can be a common complication of labial adhesions.

• #21 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. […] 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.

• #22 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

  Labial adhesions have a prevalence of approximately 1.8% in infants aged 13-23 mo, however, they are rarely found in adult women, especially in women of reproductive age. […] Few cases have been reported in postmenopausal women. Labial adhesion is caused by various inflammatory diseases and estrogen deficiency. […] Labial adhesions in postmenopausal women cannot be successfully treated with estrogen creams, and surgical treatment should be considered. […] Labial adhesion is a rare condition in postmenopausal women, and its prevalence in South Korea is unknown. […] The main symptom in these reports was difficulty in urinating. […] There was no response with topical estrogen treatment, and all cases required surgery. […] The patient in this case presented with urinary tract infection symptoms that did not improve with conventional treatment.

• #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

  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. […] Labial fusion is a benign genital disorder which is most commonly described in prepubertal girls, and less often reported in postmenopausal women. The etiology of labial fusion in the reproductive or postmenopausal age group is unknown. […] 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. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment.

• #24 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

  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.

• #25 📃 Labial fusion

  https://thefetus.net/content/labial-fusion-1/

  Adhesion or fusion of the labia is a common benign gynecologic disorder in the pediatric population and is defined as partial or complete adherence of the labia minora or majora. […] This was essentially a urinoma that developed due to fusion of labial folds leading to obstruction of the urinary flow. […] According to the data in the published literature, labial adhesion is occasionally seen in the newborn period. The age at which this disorder is commonly seen ranges from 13-23 months with an incidence of 1.8%. […] Labial fusion may be the presenting feature of genital lichen sclerosus. […] Labial adhesions can be adhesions of the labia minora or of the majora. The labia minora adhesions are a more common occurrence and more easily rectifiable. […] This disorder follows a benign course and has good prognosis.

• #26

  https://111.wales.nhs.uk/labialfusion/

  Labial fusion, or labial adhesion, is when the small inner lips around the entrance to the vagina become sealed together. […] Labial fusion is not linked to any medical condition and has no long-term implications for your child. […] In most cases, a fusion corrects itself during puberty.

• #27 Labial fusion

  https://www.rch.org.au/kidsinfo/fact_sheets/Labial_fusion/?hc_location=ufi

  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. […] There is no relationship between labial fusion and any other medical conditions. 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.

• #28 Labial Fusion in Girls: Causes, Symptoms, and Treatment Options for Parents

  https://www.dremilmammadov.com/post/labial-fusion-in-girls-causes-symptoms-and-treatment-options-for-parents

  Labial fusion, or labial adhesion, is a condition where the small inner lips around the entrance to the vagina (the labia minora) become stuck together. It is fairly common in girls under 7 years old and is usually nothing to worry about. […] The exact cause of labial fusion is not known, but it may happen as a result of irritation or inflammation of the vaginal area, known as vaginitis. […] For most girls, labial fusion does not cause any problems or discomfort and does not affect their health or development. […] In most cases, labial fusion does not need any treatment and will separate naturally by the time your daughter reaches puberty. […] No, labial fusion will not have any impact on your daughter’s future sexual health or fertility. Labial fusion does not affect the development of the uterus (womb), ovaries or fallopian tubes, which are responsible for reproduction.

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

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

  The results of this study have led to a change in clinical practice there is now a considerably more conservative approach to the treatment of labial adhesion at St. Olavs Hospital. Treatment is reserved for girls in whom the accompanying symptoms are believed to outweigh the potential drawbacks associated with treatment.

• #30 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. […] 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. […] Your local GP or family doctor can normally diagnose this condition. There is no need to see a specialist. As long as the fusion is not causing a problem it can be left alone until it disappears. […] The safest, most effective and least stressful thing to do is no treatment.

• #31 childnurture.com

  https://www.childnurture.com/article/labial-fusion

  Medical intervention to hurriedly separate the labia is not recommended because there is high risk of relapse, since actual wounds, which are more difficult to deal with, are caused. This procedure also includes unnecessary pain and trauma, and psychological damage may also be done, causing the girl to feel that something bad is happening to her body. The most effective and safe therapeutic treatment is no treatment, leaving the area completely without intervention. […] It has not been found to increase the frequency of urinary tract infections. Even a 1 mm opening is adequate for the outlet of urine. The girl’s fertility is not affected. In adult life, there is no effect on sexual function and pleasure. […] It is a common finding. It usually does not cause any symptoms, and is not related to any other complications. Simple monitoring by the paediatrician in the usual manner is adequate. There is no need for referral to a specialist. Normally, and without intervention, the fusion will separate by itself in the course of time, and usually before the girl’s first menstrual period. […] As with normal phimosis in boys, the most effective, safest, painless, and stress-free thing to do is NOT INTERVENE AT ALL.

• #32 Labial Adhesions – MD Searchlight

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

  Labial adhesions can be treated in several ways. If the patient does not show any symptoms, treatment is not required, and reassurance and guidance on maintaining good hygiene are recommended. However, when treatment is needed, it often involves applying a cream that contains estrogen directly to the affected area. This method is successful in up to 90% of cases and is commonly used when the patient has a urinary tract infection. […] Surgical intervention is usually considered after trying topical treatments, and recurrence rates range from 11% to 14% with either topical or surgical treatments.

• #33 Labial Agglutination in a Prepubertal Girl: Effect of Topical Oestrogen | HTML | Acta Dermato-Venereologica

  https://www.medicaljournals.se/acta/content/html/10.2340/00015555-0586

  Symptomatic or complete labial agglutination is treated with topical oestrogen therapy (Premarin vaginal cream with a concentration of conjugated oestrogens of 0.625 mg/g) applied 13 times daily in 18 weeks. […] The recurrence rate of labial fusion observed in a retrospective study of 109 girls was 41%. […] An alternative medical treatment is to apply a thin layer of 0.05% betamethasone cream twice daily along the adhesion line for 46 weeks. […] Topical steroid treatment was tried in our case without success. […] If the child does not respond to topical treatment, the adhesion can be separated mechanically, e.g. manual separation under topical anaesthesia with EMLA. […] The different treatments have potential side-effects. […] It is important to educate parents and carers in the awareness of the benign nature of the agglutinations, the causative mechanisms and the natural resolution.

• #34 Management of labial adhesion in a developing country—an observational study | Egyptian Pediatric Association Gazette | Full Text

  https://epag.springeropen.com/articles/10.1186/s43054-021-00089-5

  Labial adhesion is the fusion of the labia minora or majora. The estimated prevalence of labial adhesions is 0.65%, with a peak incidence between 13 and 23 months. […] The present study was conducted to evaluate LAs presentation, management, and outcome in our center. […] The patients were evaluated for age at presentation, presenting symptoms, type of adhesions, treatment, recurrence, and follow-up. […] The prevalence of LA in the current study was 1.7%, aligning with the existing literature. […] Our management strategy differs from what is mentioned in the literature. […] Manual separation is an office procedure. […] The incidence of recurrence has wide variations from 7 to 55%. […] Despite being a benign entity, LA may be a cause of severe concern. Manual separation and use of antibiotic ointment may be a viable first option in its management with minimal recurrence.

• #35 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

  Further research is needed to better understand this condition and its relation to the genitourinary syndrome. […] Labial adhesions are difficult to detect in elderly women because they are typically not sexually active. […] 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. […] One month after the surgery, the discomfort while urinating was not present, and the adhesion did not recur. […] In addition, it requires plastic surgery aimed at preventing recurrence and reconstruction.

• #36 Bladder Outlet Obstruction Due to Recurrent Complete Labial Fusion in Postmenopausal Woman—Case Report

  https://www.mdpi.com/2075-4418/14/23/2659?type=check_update&version=2

  The postoperative use of topical estrogen creams is commonly recommended to restore mucosal integrity and address the underlying estrogen deficiency, thereby reducing the risk of recurrence. […] However, despite hormonal therapy, some patients may still experience recurrences, highlighting the importance of long-term follow-ups and individualized treatment plans.

• #37 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. […] The following are some major ways that labial adhesions may impact one’s sexual health: Dyspareunia (Painful Sexual Intercourse): One of the most prevalent and distressing effects of labial adhesions is the sensation of discomfort during sexual activity. […] 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. […] 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.

• #38 Labial adhesions – Resource Library – Sheffield Children’s NHS Foundation Trust

  https://library.sheffieldchildrens.nhs.uk/labial-adhesions/

  Labial adhesions means that the labia are stuck together. […] This usually refers to the labia minora (the inner lips) and is also known as labial fusion. […] Primary labial adhesions happen in girls before puberty, commonly aged 3 months to 8 years of age. […] This is thought to be because of a low level of oestrogen (the main female hormone). […] Primary labial adhesions in girls usually do not cause any symptoms. […] They are often found during an examination for another reason. […] Primary labial adhesions are usually mild and do not cause any problems. […] They therefore do not require treatment, and will usually resolve at the time of puberty. […] For more information, please this NHS page and video about labial fusion.

• #39 childnurture.com

  https://www.childnurture.com/article/labial-fusion

  Labial fusion is a common condition in young girls. Here, the two sides of the labia seal in the middle, hiding the entrance to the vagina. This seal usually breaks, and the labia separate naturally over the course of time, in the overwhelming majority of cases before the beginning of menstruation. There is usually no need for intervention, neither is this recommended, because it may cause more pain and anxiety to the girl without reason. In some cases, premature intervention increases the risk of new and genuine fusions, which are more difficult to treat. […] The fusion is almost never evident at birth, but it develops and becomes evident usually between the ages of 1 and 2 years. The labia stick together at the central line between them. […] Gradual separation of the labia happens naturally and slowly in the course of time, and may not be complete until primary school age. The girl does not experience any pain or other symptoms at any stage. There is usually no need for medical treatment with moisturizing or cortisone creams, or massaging of the area.

• #40

  https://link.springer.com/article/10.1007/BF00975335

  The clinical and radiological findings in fused labia are described. Some of the patients were asymptomatic. The others were referred because of a suspicion of urinary infection. Micturating cystourethrography showed collection of contrast material above the labia and marked reflux into the vagina in all patients examined. These findings were not seen after separation of the labia. […] Although the diagnosis is usually a clinical one, it is suggested that labial fusion may first be recognized by the radiologist through these cystourethrographic findings and while catheterizing the child.

• #41 Labial Fusion or Labial Adhesion – Marie Fortier & Prenato

  https://mariefortier.com/expert-advice/deliverylife-with-the-baby/your-questions/labial-fusion-or-labial-adhesion/?lang=en

  Labial fusion occurs in young girls because they dont have estrogen, which prevents adhesion. This rarely happens in babies under 3 months, given that they still have residual estrogen transmitted from their mother during pregnancy. […] Frequently this will disappear without treatment when girls reach puberty as they start gradually producing hormones. […] In most cases, the problem takes care of itself and doesnt require treatment or procedures. It will fully heal on its own as the girl grows and starts releasing hormones. […] If their ability to urinate is affected, the doctor will prescribe an estrogen hormone-based cream to separate the labia, free up the urinary meatus and prevent a future fusion. […] Operating on a child for labial fusion is very rare, but it can occur for more severe cases. The procedure takes place under general anesthesia. […] I hope this article about labial fusion has shown that it occurs more frequently than we think, and as parents of a young daughter, you can be less worried if this happens to your baby.

• #42 Labial Fusion or Labial Adhesion – Marie Fortier & Prenato

  https://mariefortier.com/expert-advice/deliverylife-with-the-baby/your-questions/labial-fusion-or-labial-adhesion/?lang=en

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