Materiały źródłowe

• #1 Labial fusion

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

  Labial fusion or adhesion usually separates naturally without treatment. […] Treatment for labial fusion is not recommended unless there are other symptoms, such as dribbling after peeing, which may cause problems or discomfort. […] Treatment is with oestrogen cream or ointment applied daily or, very rarely, surgical separation. […] A small blob of the cream or ointment is applied daily on to the central line of fusion of the inner lips of the vulva. […] This should be continued for up to 6 weeks until the membrane starts to dissolve and the labia eventually separate completely. […] Surgery is very rarely needed to treat labial fusion. […] It may be considered if an oestrogen cream or ointment does not work. […] Labial fusions are relatively easy to separate during surgery. […] A surgical separation is usually performed under a general anaesthetic, where you’re asleep, or local anaesthetic, where the area is numbed, as the procedure can be quite painful and can cause distress. […] To allow the labial edges to heal properly and prevent another labial fusion forming, it’s advised to apply an emollient, such as nappy rash cream or Vaseline, to the labia for a few weeks afterwards.

• #2 Labial Adhesion: Causes, Diagnosis & Treatment

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

  Labial adhesions occur when the inner lips of the vulva stick together. […] Estrogen creams and manual or surgical separation can treat more severe cases. […] 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. Once they reach puberty and starts producing estrogen, their labial adhesions may go away without treatment. […] If you or your child has symptoms, labial adhesion treatment may include: […] If a labial adhesion covers a large area, a provider may prescribe a conjugated estrogens vaginal cream or corticosteroid cream (betamethasone 0.5%). […] Topical treatments may not effectively treat large or thick labial adhesions. In rare cases, a provider may separate the adhesion by hand. […] Providers only surgically separate a labial adhesion if you cant pee and other treatments dont work.

• #3 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.

• #4 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. […] 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. […] 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. […] The safest, most effective and least stressful thing to do is no treatment.

• #5 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. […] Therefore, these patients are typically managed with estrogen cream when symptomatic. […] Summarize the treatment options for labial adhesions. […] When treatment is indicated, it consists of applying estrogen cream to the labial area. […] Some studies have demonstrated a success rate of up to 90% with the use of topical estrogen cream. […] Recurrences are common in labial adhesions, regardless of the mode of treatment used. […] Surgical lysis of the fusion is recommended if topical management is unsuccessful. […] 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.

• #6 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. […] However if the condition results in complications such as urinary retention, recurrent urinary tract infection or vaginitis topical therapy with estrogen or bethametazone is the first treatment option. […] Regardless of the choice of treatment the family should be counselled of the possibility of recurrence. […] In the presence of serious anatomical concerns, in cases of recurrent febrile urinary tract infection or vaginitis due to failure to drain vaginal secretions, the first-stage treatment methods are either topical estrogen-containing or topical betamethasone-containing preparations. […] Although most cases are asymptomatic and will not require treatment other than the wait and see approach, if signs of inflammation, vaginitis, or urinary tract infection develop, the traditional first-stage treatment approach is topical low-dose estrogen treatment in the form of a cream.

• #7 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. […] The use of steroid betamethasone 0.05% cream has also been described, with a reported success rate of 68%. […] Parental use of the pulldown maneuver may also facilitate gentle takedown of adhesions but may be painful for the child. Once the labia separate, an emollient (eg, A+D Original Ointment, Balmex, or Aquaphor) should be applied three to five times daily for several months to allow complete healing and minimize the chances of recurrence. […] Depending on the maturity of the child and the expectations of the parents, surgical separation may be performed in a physician’s office, with a lidocaine and prilocaine (EMLA) cream employed as a topical anesthetic.

• #8 Treatment of labial fusion with topical estrogen therapy – PubMed

  https://pubmed.ncbi.nlm.nih.gov/15821849/

  Twenty girls with labial fusion that covered at least 50% of the vaginal opening were treated with a topical estrogen cream. The cream was precisely applied to the fused area twice a day until the adhesions were totally lysed. […] We conclude that treatment of labial fusion with topical estrogen therapy is safe and effective.

• #9 Labial Adhesions | Children’s Hospital Colorado

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

  Labial adhesions typically occur in infants and young girls when estrogen levels are low and genital tissues are sensitive. […] In cases where the adhesion is small, we can use a non-medicated emollient or barrier cream for treatment, which helps to ease irritation and moisturizes the skin, making it more flexible. […] 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. […] If the doctor has prescribed estrogen cream for your daughter, apply a small (pea-sized) amount to the adhesion once or twice daily for at least two weeks or until instructed by the doctor. […] Preventing the underlying condition of vulvovaginitis often stops the recurrence of labial adhesion.

• #10 Labial Adhesions: A-to-Z Guide from Diagnosis to Treatment to Prevention | DrGreene

  https://www.drgreene.com/articles/labial-adhesions

  By far the most common form of vaginal obstruction in little girls is fusion of the labia minora because of labial adhesions. […] With treatment, the adhesions will disappear quickly, often within one week. […] If treatment is needed or preferred, the natural process can be accelerated with the application of topical estrogen. A hormone cream such as Premarin should readily open the labia, usually within a week. […] To prevent new adhesions, apply a lubricant such as KY jelly or A D ointment to the labia every night for 2 -3 months. […] If you do use an estrogen cream, you should be aware that some girls will have other transient estrogen effects, including increased breast tissue and darkening of the labia and/or nipples. […] Preventing irritation to the labia will sometimes prevent adhesions. […] If irritation begins to develop, applying a lubricant such as Vaseline or A D ointment to the labia may prevent adhesions from forming.

• #11 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. […] In most cases, labial fusion does not need any treatment and will separate naturally by the time your daughter reaches puberty. This happens slowly and painlessly and she will not notice it happening. Treatment is only recommended if labial fusion is causing significant problems or symptoms. The main treatment options are: […] Oestrogen cream or ointment: This is applied daily on the join for up to 2 weeks until the membrane dissolves and the labia separate completely. You should stop applying the cream when the join separates. Oestrogen cream or ointment can sometimes cause side effects, such as tenderness in the chest or darkening of the skin in the genital area. These should go away after stopping the cream.

• #12 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

  Topical betamethasone (0.05-0.01% concentration) treatment is the most commonly preferred agent. […] If LF does not regress with medical treatment or recurrence develops with repeated applications, manual separation of the labia or surgical separation with a sharp incision may be required. […] Regardless of the method used in treatment, the family should be informed about the possibility of recurrence.

• #13 Labial fusion – Wikipedia

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

  Labial fusion is a medical condition of the vulva where the labia minora become fused together. It is generally a pediatric condition. […] Treatment is not usually necessary in asymptomatic cases, since most fusions will separate naturally over time, but may be required when symptoms are present. The standard method of treatment for labial fusion is the application of topical estrogen cream onto the areas of adhesion, which is effective in 90% of patients. […] In severe cases where the labia minora are entirely fused, causing urinary outflow obstruction or vaginal obstruction, the labia should be separated surgically. […] Recurrence after treatment is common but is thought to be prevented by good hygiene practices. […] One study has shown that betamethasone may be more effective than estrogen cream in preventing recurrence, with fewer side effects.

• #14 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. […] 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. […] Large adhesions may require application of a mild emollient or petroleum jelly and gentle manual pressure to separate the labia. Adhesions that block the vaginal or urinary openings may be treated with a prescription estrogen-based cream or steroid cream (bethamethasone) and may need a minor procedure to separate the labia. […] A pediatrician can treat most labial adhesions, but some cases are referred to a pediatric urologist. Pediatric urologists may use an office procedure like manual separation or in rare instances a short outpatient surgery to separate the labia.

• #15 Labial agglutination

  https://www.aboutkidshealth.ca/labialagglutination

  Labial agglutination occurs when the skin around the vagina sticks together. Read about possible treatments including estrogen cream and zinc oxide. […] 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. […] 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. […] Whichever cream is prescribed, it may take several weeks to open the labia. […] Rarely, if the cream does not work, surgery may be needed. […] To stop it from coming back, keep using barrier creams such as petroleum jelly and zinc oxide on the labia. […] If the problem does come back, use estrogen and barrier creams as before.

• #16 Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report

  https://www.mdpi.com/2036-7503/16/3/47

  Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report […] Background: Labial adhesions, a frequent gynecological condition in prepubertal girls, occur when the labia minora adhere along the midline. The prevailing hypothesis about their etiology suggests that labial adhesion may occur when the delicate and non-estrogenized labia minora undergo an inflammatory response, triggered by exposure to an irritant environment. Therefore, conservative treatment involves the application of topical estrogen or betamethasone cream. The role of androgens has not been considered yet in the pathophysiology or therapy of this condition. However, some studies have shown that androgen receptors are prevalent in the labia minora and vulvar vestibule. […] Conclusions: Both androgens and estrogens play a significant role in maintaining the physiological trophic state of the vulva and vagina, even during childhood. Topical estriol+testosterone could be considered an alternative treatment for prepubertal labial adhesions refractory to standard topical therapy.

• #17 Treatment of Prepubertal Labial Adhesions with Topical Estriol + Testosterone: A Case Report

  https://www.mdpi.com/2036-7503/16/3/47

  In our opinion, an ointment containing both estrogens and androgens should be considered for the treatment of labial adhesions. Further studies are needed to assess if the addition of topical testosterone can enhance the efficacy and reduce the recurrence of labial adhesions without significant side-effects.

• #18

  https://journals.lww.com/amsr/fulltext/2022/05000/labial_adhesions__a_novel_therapeutic_approach.8.aspx

  Labial adhesion is a common condition found in girls before puberty. Mometasone cream was applied topically over the labial adhesions with a positive therapeutic response within 38 weeks of treatment. […] Hence, it can be concluded that mometasone cream is an effective method of treatment for labial adhesions. […] Mometasone cream was applied topically over the adhesions with a good therapeutic response within 38 weeks of treatment, and very minor side effects were noted only in two cases. […] In our study, we have used mometasone cream for the treatment for labial adhesion cases and an effective therapeutic response was observed with negligible side effects. It can be concluded that mometasone cream can be used effectively for the treatment for labial adhesions.

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

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

  Labial adhesions often have no symptoms and are uncovered during a routine physical exam. […] 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. During several weeks of using the cream, the adhesions should soften and begin to separate. […] 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.

• #20 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

  Various treatment options include topical estrogen, topical betamethasone, manual, and surgical separation. The choice of treatment depends on the age group and the type of adhesions. In the postpubertal group, often manual or surgical separation is required as they are often thick and dense. Conjugated estrogen cream or estradiol vaginal cream (0.01%) is applied to the adhesions 12 times daily for several weeks until the adhesion resolves. Alternatively, topical 0.05% betamethasone for 46 weeks can be considered for one to three courses twice everyday. Manual separation can be tried in thin adhesions not responding to medical management. But traumatic lysis should be avoided as it can lead to recurrence with the development of more dense adhesions. Surgical separation is reserved for thick dense adhesions, thin adhesions not responding to other treatments and recurrent cases. Both patients had thick adhesions. Hence, surgical separation was performed with postoperative application of topical estrogen and antibiotics to promote healing and prevent recurrence. Surgical technique includes division of adhesions by gentle traction or running a sound along the fusion line.

• #21 Labial Adhesions – RefHelp

  https://apps.nhslothian.scot/refhelp/guidelines/paediatricsurgery/labial-adhesions/

  Most girls with labial adhesion do not have any symptoms and the usual concern of the carer is the appearance of the external genitalia. […] A small number of girls may complain of discomfort in the genital area, lower urinary tract symptoms and rarely urinary tract infection. This would merit management as below. […] For symptomatic girls who do not respond to simple hygiene measures, topical treatment to the labial adhesion with an oestrogen containing cream (twice daily for 6 weeks) may allow the labial tissue to become more supple and the adhesions may open up and separate. The adhesions may reform once the cream is discontinued. This therapy can be safely prescribed in primary care without paediatric surgical review. […] For symptomatic girls who do not respond to simple hygiene measures or oestrogen then a surgical review may be beneficial.

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

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

  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.

• #23 :: 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. […] Surgical separation of the labia by blunt dissection was then performed, and clobetasol ointment and vaginal dilatators were postoperatively prescribed. This resulted in a significant improvement in her symptoms. […] Treatment for mild cases of labial adhesion includes treating the underlying condition together with TCS and topical estrogen creams. […] If there is no response to topical therapy, surgical separation under anesthesia can be performed. […] 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.

• #24 Labial Adhesions | Riley Children’s Health

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

  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.

• #25 Labial Adhesions – Center for Young Women’s Health

  https://youngwomenshealth.org/parents/labial-adhesions-parent/

  Estrogen-containing creams are safe to use for the treatment of labial adhesions. […] It is very unusual for this treatment to fail. […] If your child’s adhesions do not improve with the estrogen cream, you should discuss other treatment options with her health care provider. […] Estrogen cream is the standard treatment for labial adhesions. […] Labial adhesions can recur or come back, even after they open up. […] Once the labia are separated, Vaseline or A D ointment is used as an emollient for 6-12 months to keep the labia open and prevent or lessen irritation of the vulva area.

• #26 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”. […] In this article, you will find answers to frequently asked questions such as „Why does labial fusion occur, how often does it occur, how to diagnose it in infancy, childhood, and menopause, and how is the treatment of labial fusion and genital area adhesions?” […] The diagnosis of labia fusion is based on gynecological examination of the genital area. […] There are some determining factors for labial fusion treatment. These are: Patient’s age, The severity of complaints due to labial fusion, Whether there is another concomitant disease, Severity of labial fusion. […] There are different opinions about labial fusion treatment in infancy and childhood.

• #27 Labial Fusion in a Postmenopausal Woman Presenting with Lower Urinary Tract Symptoms: A Case Report

  https://clinmedjournals.org/articles/jgmg/journal-of-geriatric-medicine-and-gerontology-jgmg-5-074.php

  Acute or chronic lower urinary tract symptoms (LUTS) may be secondary to labial fusion in menopause. Early detection and treatment may help prevent progression of the condition. […] Surgical separation of the labial fusion, followed by use of topical estrogen, successfully restored the anatomy and voiding function in the postoperative two-year follow-up period. […] Surgery in conjunction with topical treatment could be effective in elderly patients with labial fusion. […] Topical estrogen cream is considered as the treatment of choice in these patients. […] Surgical separation is indicated in any age group if the response to medical treatment is poor, or if scarred or thick adhesion exists. […] With surgical labial separation alone, there is some risk of readhesion. Thus, postoperative use of topical estrogen, antibacterial, or emollient therapy are helpful to minimize recurring agglutination. […] Surgical separation followed by topical estrogen may contribute to satisfactory and favorable outcomes.

• #28 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 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.

• #29 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 treatment is not well established, owing to low prevalence in menopausal population. The most common methods of treatment are manual separation and surgical excision. Postoperative application of local estrogen cream is vital to prevent recurrence. […] The woman was treated with surgical division of adhesion followed by local application of estrogen. The patient had complete resolution of symptoms, with no recurrence till one year of follow up. […] Local application of estrogen cream is treatment of choice in these patients, due to natural decline in production of estrogen by ovaries. […] Surgical separation followed by estrogen application is usually the treatment of choice.

• #30 Labial Adhesion: Causes, Diagnosis & Treatment

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

  The outlook for labial adhesions is good. They often go away without treatment once your child begins menstruating. If treatment is necessary, the success rate is good. […] Labial adhesions often go away on their own when your child reaches puberty and starts producing estrogen. […] Talk to a provider if you have any symptoms.

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

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

  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. […] Very rarely, doctors will need to do a simple surgery to separate the adhesions. […] Labial adhesions do not cause any lasting problems. Later in life, they wont affect your childs sexuality or fertility (ability to have children).

• #32 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

  Surgery: This is very rarely needed and only considered if oestrogen cream or ointment does not work or if there is trapped urine in the vagina. […] 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.

• #33 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. 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.

• #34 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. 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. A study by Wejde et al suggested that manual separation may yield better overall final outcomes than topical estrogen. […] 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.

• #35 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. […] 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.

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