Materiały źródłowe

• #1 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. […] 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. It is thought to occur in a hypoestrogenic state due to it being very uncommon in the newborn period when there is maternal estrogen influence as well as during the reproductive period when there are adequate estrogen levels. […] Some studies are against the idea that labial fusion is due to a hypoestrogenic state. A study in 2007 published in „Pediatric Dermatology” that measured the serum estradiol levels of 59 prepubertal females with labial adhesion and 60 prepubertal females showed no statistically significant difference in their estrogen levels.

• #2 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/n/statpearls/article-23971/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. […] 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. It is thought to occur in a hypoestrogenic state due to it being very uncommon in the newborn period when there is maternal estrogen influence as well as during the reproductive period when there are adequate estrogen levels. […] Some studies are against the idea that labial fusion is due to a hypoestrogenic state. A study in 2007 published in „Pediatric Dermatology” that measured the serum estradiol levels of 59 prepubertal females with labial adhesion and 60 prepubertal females showed no statistically significant difference in their estrogen levels.

• #3 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 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). […] 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.

• #4 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/n/statpearls/article-23971/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. […] 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. It is thought to occur in a hypoestrogenic state due to it being very uncommon in the newborn period when there is maternal estrogen influence as well as during the reproductive period when there are adequate estrogen levels. […] Some studies are against the idea that labial fusion is due to a hypoestrogenic state. A study in 2007 published in „Pediatric Dermatology” that measured the serum estradiol levels of 59 prepubertal females with labial adhesion and 60 prepubertal females showed no statistically significant difference in their estrogen levels.

• #5 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. […] The primary contributing factor to labial fusion is low estrogen levels. A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.

• #6 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 may be due to oestrogen deficiency, particularly in non-sexually active women after the menopause. […] 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.

• #7 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. […] What causes labial adhesions? […] But labial adhesions may relate to low estrogen levels. […] Girls have low estrogen levels before they start puberty. […] In adults, labial adhesions may develop shortly after childbirth or after menopause. […] Labial adhesions often go away on their own when your child reaches puberty and starts producing estrogen.

• #8 What Is a Labial Fusion?

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

  A labial fusion, also known as a labial adhesion, occurs when the inner lips (labia minor) of the vagina become sealed together. […] It is currently unclear what causes a labial fusion, but physicians have linked it to low estrogen levels in young girls and women. […] Although there is a link between labial fusions and low estrogen levels, there are also a few other known causes of the actual fusion, or sealing, of the labia in female children and women. […] Several different types of skin irritation can contribute to labial fusion. […] Vaginitis has also been linked to labial fusions, as it oftentimes accompanies inflammation of the vagina. […] After a vaginal delivery, there are often some lacerations in the vaginal area that can also lead to infection. This infection can cause a build-up of fluids that can contribute to distorted anatomical healing, including a labial fusion.

• #9 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 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.

• #10 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. […] Labial fusion, or agglutination, is defined as partial or complete adhesion of the labia minora or majora at the midline of the vulva. Labial fusion in postmenopausal women is very rare. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Estrogen insufficiency also occurs in postmenopausal women, however, women in this age group rarely have labial fusion. […] Timely treatment for those factors may prevent the formation of vulvar adhesion. […] Topical estrogen cream is considered as the treatment of choice in these patients.

• #11 What Is a Labial Fusion?

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

  Trauma to the vaginal area can also lead to labial fusions, as trauma often leads to inflammation of the affected area. […] When a woman is breastfeeding, her body often experiences an increase in serum prolactin. This leads to a hypo-estrogenic state in the woman’s body, meaning she is experiencing lower levels of estrogen. After childbirth, this lower level of estrogen coupled with edema or trauma to the vaginal area can lead to labial fusions. […] Labial fusions often heal on their own with little intervention needed from doctors and medications. […] Since low estrogen levels are a primary cause of susceptibility to skin irritation and infections in women and children, introducing an estrogen topical cream into your or your child’s daily routine may help alleviate labial fusion symptoms. […] In extreme cases, surgery is offered as treatment. This is most often the case in instances where labial fusion is preventing urination or causing infections. […] Labial fusions are not linked to other medical conditions and have not proven to have long-term effects on those who recover.

• #12 Labial Adhesions – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/sites/books/n/statpearls/article-23971/

  Labial adhesion is the fusion of the labia minora or majora, and it is mostly located near the clitoris. The exact cause for labial adhesions remains unknown. However, it is believed that a state of low estrogen may be a contributing cause. […] 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. It is thought to occur in a hypoestrogenic state due to it being very uncommon in the newborn period when there is maternal estrogen influence as well as during the reproductive period when there are adequate estrogen levels. […] Some studies are against the idea that labial fusion is due to a hypoestrogenic state. A study in 2007 published in „Pediatric Dermatology” that measured the serum estradiol levels of 59 prepubertal females with labial adhesion and 60 prepubertal females showed no statistically significant difference in their estrogen levels.

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

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

  Labial adhesions are fibrous adhesions between the labia minora. Low estrogen levels have been thought to play a causative role in their formation, and the protective effect of maternal estrogen makes labial adhesions uncommon during the newborn period. […] However, a 2007 study found no statistically significant difference in serum estradiol levels between infants with labial adhesions and control subjects. […] Labial adhesions may also be caused by vaginal inflammation, local irritation, or tissue trauma. They have been reported to result from childhood sexual abuse and may be associated with lacerations or hematoma.

• #14 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. […] 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. It is thought to occur in a hypoestrogenic state due to it being very uncommon in the newborn period when there is maternal estrogen influence as well as during the reproductive period when there are adequate estrogen levels. […] Some studies are against the idea that labial fusion is due to a hypoestrogenic state. A study in 2007 published in „Pediatric Dermatology” that measured the serum estradiol levels of 59 prepubertal females with labial adhesion and 60 prepubertal females showed no statistically significant difference in their estrogen levels.

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

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

  Labial adhesions are fibrous adhesions between the labia minora. Low estrogen levels have been thought to play a causative role in their formation, and the protective effect of maternal estrogen makes labial adhesions uncommon during the newborn period. […] However, a 2007 study found no statistically significant difference in serum estradiol levels between infants with labial adhesions and control subjects. […] Labial adhesions may also be caused by vaginal inflammation, local irritation, or tissue trauma. They have been reported to result from childhood sexual abuse and may be associated with lacerations or hematoma.

• #16 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 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). […] 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.

• #17 Labial fusion

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

  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. […] While doctors are not sure exactly how labial fusion occurs, it often seems to happen following an infection in the vulval area, such as vulvovaginitis, or after minor trauma, like a injury from horse riding. […] Yes. After the labia have separated, which in most cases happens on its own by puberty, there will be no lasting damage to the labia. Your daughter will be able to menstruate without problems, and her future fertility and ability to have sexual intercourse will not be affected.

• #18 What Is a Labial Fusion?

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

  A labial fusion, also known as a labial adhesion, occurs when the inner lips (labia minor) of the vagina become sealed together. […] It is currently unclear what causes a labial fusion, but physicians have linked it to low estrogen levels in young girls and women. […] Although there is a link between labial fusions and low estrogen levels, there are also a few other known causes of the actual fusion, or sealing, of the labia in female children and women. […] Several different types of skin irritation can contribute to labial fusion. […] Vaginitis has also been linked to labial fusions, as it oftentimes accompanies inflammation of the vagina. […] After a vaginal delivery, there are often some lacerations in the vaginal area that can also lead to infection. This infection can cause a build-up of fluids that can contribute to distorted anatomical healing, including a labial fusion.

• #19 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 arises in infants when there is very little circulating oestrogen hormone (American spelling estrogen). It is thought the adhesion occurs after local irritation by urine, scratching or uncomfortable underwear (contact irritant dermatitis), or after urinary infection. […] If treatment is necessary, oestrogen cream may be prescribed to apply to the labia and is usually successful. At first a small amount is applied once daily for 2-4 weeks. Once the labia are separated, oestrogen cream can usually be stopped and replaced by an emollient cream for a few months. In some girls, oestrogen cream may need to be applied intermittently (perhaps once or twice weekly) until puberty is established. […] Surgery may be required to divide severe fibrous adhesion using local anaesthetic cream or under general anaesthesia. Oestrogen cream is usually prescribed afterwards to prevent the labia sticking together again.

• #20 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 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). […] 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. […] 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.

• #21 Labial fusion – GPnotebook

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

  labial fusion/labial adhesions may be defined as the partial or complete adherence of the apposing vulval labia minora […] believed to be most often an acquired clinical condition rather than a congenital anomaly […] „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 […] labial fusion has been described as a result of childhood genital lichen sclerosis, primary genital herpes, and chronic inflammation such as recurrent vulvovaginitis and urinary tract infections […] treatment methods described to divide labial adhesions vary considerably and include oestrogen cream, blunt or sharp surgical dissection under general anaesthesia, oral estrogen, bland emollients, and observation alone.

• #22 Labial adhesions | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labial-adhesions

  The cause of labial adhesions is thought to be irritation to the labia minora: for example, poor hygiene, strongly perfumed soaps and inflammatory conditions like vulvitis. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. […] Low oestrogen levels (hypo-oestrogenism) are also thought to contribute to the development of labial adhesions. […] The outer skin surface (squamous epithelial layer) of the labia minora is thin and delicate. Irritation and inflammation can cause the outer skin to become exposed and raw. The two raw lips then heal together in much the same way as any skin cut might heal. […] Labial adhesions are more common during the nappy years. […] The condition resolves during puberty because the effect of the female hormone oestrogen changes the cells that line the genitals.

• #23 Labial Fusion – narikaa.com

  https://narikaa.com/article/gynaecology-disorders/vaginal-disorders/labial-fusion/

  Labial fusion is a condition where the two flaps of skin on either side of the opening to the vagina, also known as the labia minora are joined or fused together forming a shiny membrane of inflammatory tissue. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals, as it is common in the nappy years. […] Poor genital hygiene plays the most important role in chronic inflammation. […] A labial fusion or adhesion usually separates naturally without treatment when puberty is reached. […] However, recurrence may occur if good hygiene measures are not followed. […] It does not affect the childs menstruation, fertility, or sexual life in the future.

• #24 Labial fusion

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

  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. […] While doctors are not sure exactly how labial fusion occurs, it often seems to happen following an infection in the vulval area, such as vulvovaginitis, or after minor trauma, like a injury from horse riding. […] Yes. After the labia have separated, which in most cases happens on its own by puberty, there will be no lasting damage to the labia. Your daughter will be able to menstruate without problems, and her future fertility and ability to have sexual intercourse will not be affected.

• #25 Labial fusion – GPnotebook

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

  labial fusion/labial adhesions may be defined as the partial or complete adherence of the apposing vulval labia minora […] believed to be most often an acquired clinical condition rather than a congenital anomaly […] „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 […] labial fusion has been described as a result of childhood genital lichen sclerosis, primary genital herpes, and chronic inflammation such as recurrent vulvovaginitis and urinary tract infections […] treatment methods described to divide labial adhesions vary considerably and include oestrogen cream, blunt or sharp surgical dissection under general anaesthesia, oral estrogen, bland emollients, and observation alone.

• #26 Labial adhesions | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labial-adhesions

  The cause of labial adhesions is thought to be irritation to the labia minora: for example, poor hygiene, strongly perfumed soaps and inflammatory conditions like vulvitis. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. […] Low oestrogen levels (hypo-oestrogenism) are also thought to contribute to the development of labial adhesions. […] The outer skin surface (squamous epithelial layer) of the labia minora is thin and delicate. Irritation and inflammation can cause the outer skin to become exposed and raw. The two raw lips then heal together in much the same way as any skin cut might heal. […] Labial adhesions are more common during the nappy years. […] The condition resolves during puberty because the effect of the female hormone oestrogen changes the cells that line the genitals.

• #27 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Causes Of labial adhesion in PrePubertal Girls Exact cause is uncertain Microtraumas like overcleaning causing mechanical mucosal injury of the perineum == Lead to adhesion of labia minora […] The most common causes of labial adhesion in adult women (PostPartum, PostMenopausal) Oestrogen deficiency associated with atrophic vaginitis […] Symptoms Labial adhesions are usually asymptomatic […] Signs Labial fusion is diagnosed by visual inspection […] Spontaneous resolution 50% in cases within 6 months 90% in cases within 12 months 100% in cases within 18 months […] If there are no symptoms and no problems in urinating, the doctor might want to wait for the girl to reach puberty and start to produce estrogen […] Leaving labial fusion alone is the safest and most effective treatment.

• #28 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. […] Labial fusion, or agglutination, is defined as partial or complete adhesion of the labia minora or majora at the midline of the vulva. Labial fusion in postmenopausal women is very rare. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Estrogen insufficiency also occurs in postmenopausal women, however, women in this age group rarely have labial fusion. […] Timely treatment for those factors may prevent the formation of vulvar adhesion. […] Topical estrogen cream is considered as the treatment of choice in these patients.

• #29 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?jid=jgmg

  Acute or chronic lower urinary tract symptoms (LUTS) may be secondary to labial fusion in menopause. […] Labial fusion, or agglutination, is defined as partial or complete adhesion of the labia minora or majora at the midline of the vulva. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Estrogen insufficiency also occurs in postmenopausal women, however, women in this age group rarely have labial fusion. […] Timely treatment for those factors may prevent the formation of vulvar adhesion. […] Topical estrogen cream is considered as the treatment of choice in these patients.

• #30 :: 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. […] Clues for the diagnosis of LS in this case, where the lesions of both conditions where overlapping, includes dyspareunia, pruritus and fusion of the labia, which are indicative of a scarring condition and should prompt to perform a biopsy.

• #31 Labial Fusing and Vulvar Lichen Sclerosus – Lichen Sclerosus Support Network

  https://lssupportnetwork.org/labial-fusing-and-vulvar-lichen-sclerosus/

  Labial fusing is something that many of us (though certainly not all) experience with vulvar lichen sclerosus (VLS). […] Fusing in the context of VLS means one part of the vulva sticking to another part of the vulva. For example, the labia minora can stick to be and become ‘stuck’ to the labia majora. […] As fusing progresses, it can become increasingly stuck to another part of the vulva; the result for some of us can be resorption. Resorption is when one part (e.g., labia minora) becomes absorbed into another part (e.g., the labia majora) such that you can no longer feel two distinct parts of the anatomy. […] If you do not yet have fusing or have some fusing, you may want to know if you can do anything to decrease your chances of fusing. […] You can do a few things to decrease your chances of fusing, although none are a guarantee. The human body is too complex to guarantee these types of things.

• #32 :: 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. […] Clues for the diagnosis of LS in this case, where the lesions of both conditions where overlapping, includes dyspareunia, pruritus and fusion of the labia, which are indicative of a scarring condition and should prompt to perform a biopsy.

• #33 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 arises in infants when there is very little circulating oestrogen hormone (American spelling estrogen). It is thought the adhesion occurs after local irritation by urine, scratching or uncomfortable underwear (contact irritant dermatitis), or after urinary infection. […] If treatment is necessary, oestrogen cream may be prescribed to apply to the labia and is usually successful. At first a small amount is applied once daily for 2-4 weeks. Once the labia are separated, oestrogen cream can usually be stopped and replaced by an emollient cream for a few months. In some girls, oestrogen cream may need to be applied intermittently (perhaps once or twice weekly) until puberty is established. […] Surgery may be required to divide severe fibrous adhesion using local anaesthetic cream or under general anaesthesia. Oestrogen cream is usually prescribed afterwards to prevent the labia sticking together again.

• #34 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 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.

• #35 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 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.

• #36 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?jid=jgmg

  Acute or chronic lower urinary tract symptoms (LUTS) may be secondary to labial fusion in menopause. […] Labial fusion, or agglutination, is defined as partial or complete adhesion of the labia minora or majora at the midline of the vulva. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Estrogen insufficiency also occurs in postmenopausal women, however, women in this age group rarely have labial fusion. […] Timely treatment for those factors may prevent the formation of vulvar adhesion. […] Topical estrogen cream is considered as the treatment of choice in these patients.

• #37 Labial adhesions | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labial-adhesions

  The cause of labial adhesions is thought to be irritation to the labia minora: for example, poor hygiene, strongly perfumed soaps and inflammatory conditions like vulvitis. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. […] Low oestrogen levels (hypo-oestrogenism) are also thought to contribute to the development of labial adhesions. […] The outer skin surface (squamous epithelial layer) of the labia minora is thin and delicate. Irritation and inflammation can cause the outer skin to become exposed and raw. The two raw lips then heal together in much the same way as any skin cut might heal. […] Labial adhesions are more common during the nappy years. […] The condition resolves during puberty because the effect of the female hormone oestrogen changes the cells that line the genitals.

• #38 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Causes Of labial adhesion in PrePubertal Girls Exact cause is uncertain Microtraumas like overcleaning causing mechanical mucosal injury of the perineum == Lead to adhesion of labia minora […] The most common causes of labial adhesion in adult women (PostPartum, PostMenopausal) Oestrogen deficiency associated with atrophic vaginitis […] Symptoms Labial adhesions are usually asymptomatic […] Signs Labial fusion is diagnosed by visual inspection […] Spontaneous resolution 50% in cases within 6 months 90% in cases within 12 months 100% in cases within 18 months […] If there are no symptoms and no problems in urinating, the doctor might want to wait for the girl to reach puberty and start to produce estrogen […] Leaving labial fusion alone is the safest and most effective treatment.

• #39 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. […] The primary contributing factor to labial fusion is low estrogen levels. A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.

• #40 Labial Adhesion in a Pubertal Girl—A Commonly Misdiagnosed Entity: A Case Report

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/23933/JPJ/fullText

  Labial adhesion is a gynecological condition where adhesion of labia minora occurs in the midline. […] Hypoestrogenism and inflammation are usually considered as a cause of labial adhesion. […] Labial adhesion is the partial or complete fusion of labia minora in the midline and is usually asymptomatic. […] Recurrence is a common problem in labial adhesions. […] Labial adhesion is thought to develop during the re-epithelization of microtraumatized hypoestrogenism labial skin, vulvovaginitis, and poor local hygiene. […] Hypoestrogenism may also not be the cause in our case as she had attained menarche and had her secondary sexual characters developed. […] Diagnosis is by inspection of the vulva. […] Time and again, clinical examination proved to be critical. […] Asymptomatic adhesions need no treatment.

• #41 Labial adhesions | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labial-adhesions

  The cause of labial adhesions is thought to be irritation to the labia minora: for example, poor hygiene, strongly perfumed soaps and inflammatory conditions like vulvitis. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. […] Low oestrogen levels (hypo-oestrogenism) are also thought to contribute to the development of labial adhesions. […] The outer skin surface (squamous epithelial layer) of the labia minora is thin and delicate. Irritation and inflammation can cause the outer skin to become exposed and raw. The two raw lips then heal together in much the same way as any skin cut might heal. […] Labial adhesions are more common during the nappy years. […] The condition resolves during puberty because the effect of the female hormone oestrogen changes the cells that line the genitals.

• #42 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #43 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. […] The primary contributing factor to labial fusion is low estrogen levels. A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.

• #44 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

  Diagnosis is made on physical examination which shows the fused labia minora with or without the involvement of labia majora. The typical appearance is a flat appearing genitalia and a midline vertical translucent membrane which can be thin and fragile or thick and dense. […] 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. […] Recurrent labial fusion is a difficult situation both for the patient and for the treating gynecologist. It is not uncommon reported to occur in 11-14%. It can be seen after treatment in all age groups and after all forms of treatment.

• #45 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. […] What causes labial adhesions? […] But labial adhesions may relate to low estrogen levels. […] Girls have low estrogen levels before they start puberty. […] In adults, labial adhesions may develop shortly after childbirth or after menopause. […] Labial adhesions often go away on their own when your child reaches puberty and starts producing estrogen.

• #46 Labial Fusion

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

  Labial fusion refers to partial or complete adherence of the labia minora. The condition is rare at birth and occurs most commonly in girls between 3 months and 4 years of age. The peak incidence is between 13 and 23 months, during which about 3.3% of girls are affected. […] Labial fusion probably develops after denudation of the superficial squamous epithelial layer of the labial mucosa. Denudation occurs with inflammatory conditions of the labia minora, such as vulvitis or vulvovaginitis, most often secondary to poor perineal hygiene. Estrogen deficiency is associated with a reduction in the thickness of the labial epithelial cells and is a possible pathogenic factor. […] Labial fusion may predispose the child to asymptomatic bacteriuria or to urinary tract infection. Occasionally, the labial fusion causes urinary outflow obstruction with resultant bladder distention and hydronephrosis.

• #47 Labial Fusion

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

  Labial fusion refers to partial or complete adherence of the labia minora. The condition is rare at birth and occurs most commonly in girls between 3 months and 4 years of age. The peak incidence is between 13 and 23 months, during which about 3.3% of girls are affected. […] Labial fusion probably develops after denudation of the superficial squamous epithelial layer of the labial mucosa. Denudation occurs with inflammatory conditions of the labia minora, such as vulvitis or vulvovaginitis, most often secondary to poor perineal hygiene. Estrogen deficiency is associated with a reduction in the thickness of the labial epithelial cells and is a possible pathogenic factor. […] Labial fusion may predispose the child to asymptomatic bacteriuria or to urinary tract infection. Occasionally, the labial fusion causes urinary outflow obstruction with resultant bladder distention and hydronephrosis.

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

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

  Labial adhesions are fibrous adhesions between the labia minora. Low estrogen levels have been thought to play a causative role in their formation, and the protective effect of maternal estrogen makes labial adhesions uncommon during the newborn period. […] However, a 2007 study found no statistically significant difference in serum estradiol levels between infants with labial adhesions and control subjects. […] Labial adhesions may also be caused by vaginal inflammation, local irritation, or tissue trauma. They have been reported to result from childhood sexual abuse and may be associated with lacerations or hematoma.

• #49 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #50 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 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.

• #51 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. […] The primary contributing factor to labial fusion is low estrogen levels. A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.

• #52 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. […] The reasons why labial adhesions occur are not known, but we do believe that estrogen may play a role. […] A chronic inflammatory process as the result of fecal soiling, vulvovaginitis, eczema or dermatitis can also play a role in the development of the adhesion. […] 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.

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

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

  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. […] The etiology of this condition is not entirely clear, and the general theory is that labial fusion can occur when the vulnerable and thin non-estrogenized labia minora develop an inflammatory reaction due to the exposure to a local irritant setting. […] The physiopathological base of labial adhesions is not completely clear, and many authors postulated that they could develop in girls exposed to local irritants in a low-endogenous-estrogen setting, characterized by the thin and immature epithelium of the labia minora.

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

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

  The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] Immunohistochemical and histological research has demonstrated that the amount of androgen receptors in the labia minora, labia majora, and vestibule is higher than that of estrogen receptors. […] The effect of androgen receptor activation is associated with cell proliferation, differentiation, metabolism, and apoptosis, as well as protein secretion in various tissues in both men and women. […] 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.

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

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

  The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] Immunohistochemical and histological research has demonstrated that the amount of androgen receptors in the labia minora, labia majora, and vestibule is higher than that of estrogen receptors. […] The effect of androgen receptor activation is associated with cell proliferation, differentiation, metabolism, and apoptosis, as well as protein secretion in various tissues in both men and women. […] 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.

• #56 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 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.

• #57 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?jid=jgmg

  Acute or chronic lower urinary tract symptoms (LUTS) may be secondary to labial fusion in menopause. […] Labial fusion, or agglutination, is defined as partial or complete adhesion of the labia minora or majora at the midline of the vulva. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Estrogen insufficiency also occurs in postmenopausal women, however, women in this age group rarely have labial fusion. […] Timely treatment for those factors may prevent the formation of vulvar adhesion. […] Topical estrogen cream is considered as the treatment of choice in these patients.

• #58 Labial Fusion Causing Coital and Voiding Difficulty in a Young Woman

  https://www.scirp.org/html/2-1990022_27128.htm

  Adhesions of the labia are extremely rare in the reproductive population with only a few cases described in the literature. […] Labial fusion (LF) is defined as partial or complete adhesion of the labia minora and estimated to occur in 0.6% – 5% of prepubertal girls. […] Vaginal inflammation—irritation, hypoestrogenism, local trauma, lack of sexual activity, female circumcision, vaginal lacerations in childbirth and recurrent urinary tract infections are formerly reported as the contributing factors for LF in adults. […] Labial fusion (LF), a state of partial or complete adhesion of the labia minora, generally occur in children or post-menopausal women, but is extremely rare in reproductive ages. […] The relative hypoestrogenic environment is suggested as the main predisposing factor of this disorder in prepubertal girls.

• #59 Labial Fusion Causing Coital and Voiding Difficulty in a Young Woman

  https://www.scirp.org/html/2-1990022_27128.htm

  In adults including postmenopausal women, LF is more associated with recurrent urinary tract infections, vulvovaginitis, genital trauma, hypoestrogenism and lack of sexual activity. […] Topical estrogen cream is generally accepted as the initial therapy for superficial labial adhesions which may reduce the irritation of the vaginal mucous membranes and ease subsequent repair particularly in prepubertal girls and postmenopausal women. […] Surgery should become the first option for treatment, in patients with complete, thick adhesions and a long history of LF. […] Although it is a rare event, LF should be considered in the differential diagnosis of the patients presenting with sexual dysfunction.

• #60 Labial fusion

  https://www.menopausematters.co.uk/forum/index.php?topic=69997.0

  Hi everyone, new poster here. I was wondering if anyone else is dealing with labial fusion along with LS and has any tips or meds to recommend? I’m two weeks out from my third operation to reopen my labia, I’m currently checking it twice daily in the mirror to stop it from sticking back together – which is making me very sore. […] For the fusion I’ve been prescribed Estradiol cream 3x weekly and advised to use vaseline in between, as well as using dilators. […] I also read that sometimes fusion is due to VA, not LS, although I was itchy enough that I’m fairly certain LS is an issue for me, though VA is in the mix too for sure. […] I do feel for you. It’s a horrible condition. I bet there’s loads of older women who didn’t get any treatment. […] during washing I try to massage my labia to stop fusing.

• #61 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?jid=jgmg

  Acute or chronic lower urinary tract symptoms (LUTS) may be secondary to labial fusion in menopause. […] Labial fusion, or agglutination, is defined as partial or complete adhesion of the labia minora or majora at the midline of the vulva. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Estrogen insufficiency also occurs in postmenopausal women, however, women in this age group rarely have labial fusion. […] Timely treatment for those factors may prevent the formation of vulvar adhesion. […] Topical estrogen cream is considered as the treatment of choice in these patients.

• #62

  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. […] It is caused by the midline fusion of the labia minora, and it is usually asymptomatic; it is commonly first noticed by mothers during a regular physical examination by a doctor. […] Although labial adhesions are normally asymptomatic, they can cause postvoid dribbling or vaginal voiding, which is linked to a urinary tract infection, as well as discomfort when the bladder is evacuated. […] The use of 0.05% betamethasone cream as a topical therapy has shown to be effective. […] There is a scarcity of data on the use of mometasone cream as a topical treatment for labial adhesions. […] Mometasone is a synthetic topical glucocorticoid receptor (GR) agonist with anti-inflammatory, antipruritic, and vasoconstrictive properties. Mometasone cream is a potent topical corticosteroid. It is used in inflammatory skin conditions such as severe eczema and dermatitis.

• #63

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

  Regarding the mechanism of action, mometasone cream being steroid in nature, attaches to cytoplasmic glucocorticoid receptors (GRs), the receptor and mometasone complex translocate into the nucleus, where the gene expression for various anti-inflammatory proteins is induced. This is done through inducing the lipocortin/annexin I (ANXA 1) levels. […] 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.

• #64 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. […] The reasons why labial adhesions occur are not known, but we do believe that estrogen may play a role. […] A chronic inflammatory process as the result of fecal soiling, vulvovaginitis, eczema or dermatitis can also play a role in the development of the adhesion. […] 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.

• #65

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

  Regarding the mechanism of action, mometasone cream being steroid in nature, attaches to cytoplasmic glucocorticoid receptors (GRs), the receptor and mometasone complex translocate into the nucleus, where the gene expression for various anti-inflammatory proteins is induced. This is done through inducing the lipocortin/annexin I (ANXA 1) levels. […] 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.

• #66 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. […] In the literature, terms such as labial adhesion, labial agglutination, labial fusion or synechia vulvae are used. […] The vast majority of girls with labial adhesion are asymptomatic, and this is the case irrespective of 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.

• #67 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. […] Labial fusion, or agglutination, is defined as partial or complete adhesion of the labia minora or majora at the midline of the vulva. Labial fusion in postmenopausal women is very rare. […] The etiology is multifactorial, comprised of hypoestrogenism, vulvar inflammation secondary to local infection, irritation, trauma, genital herpes, lichen sclerosus, and lack of intercourse. […] Labial fusion mostly occurs in patients in a hypoestrogenic state. […] Estrogen insufficiency also occurs in postmenopausal women, however, women in this age group rarely have labial fusion. […] Timely treatment for those factors may prevent the formation of vulvar adhesion. […] Topical estrogen cream is considered as the treatment of choice in these patients.

• #68 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. […] In the literature, terms such as labial adhesion, labial agglutination, labial fusion or synechia vulvae are used. […] The vast majority of girls with labial adhesion are asymptomatic, and this is the case irrespective of 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.

• #69 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?jid=jgmg

  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. […] We observed the stepwise development of acute urinary retention, urinary tract infection, urocolpos, post micturition dribble, and involuntary urine loss in this case over a five-year period. […] In conclusion, labial fusion in postmenopausal women is a multifactorial condition.

• #70 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 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.

• #71 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?jid=jgmg

  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. […] We observed the stepwise development of acute urinary retention, urinary tract infection, urocolpos, post micturition dribble, and involuntary urine loss in this case over a five-year period. […] In conclusion, labial fusion in postmenopausal women is a multifactorial condition.

• #72 📃 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. […] Labial fusion may be the presenting feature of genital lichen sclerosus. […] Labial adhesions may be congenital as in this case or a complication of: […] Postnatally, they may also result from inflammation that occurs secondary to various causes and resultant scarring, estrogen deficiency and lack of sexual activity. […] Hypo-estrogenic states as in pre- and postmenopausal women predispose them to developing labial adhesions.

• #73 Labial Fusion

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

  Labial fusion refers to partial or complete adherence of the labia minora. The condition is rare at birth and occurs most commonly in girls between 3 months and 4 years of age. The peak incidence is between 13 and 23 months, during which about 3.3% of girls are affected. […] Labial fusion probably develops after denudation of the superficial squamous epithelial layer of the labial mucosa. Denudation occurs with inflammatory conditions of the labia minora, such as vulvitis or vulvovaginitis, most often secondary to poor perineal hygiene. Estrogen deficiency is associated with a reduction in the thickness of the labial epithelial cells and is a possible pathogenic factor. […] Labial fusion may predispose the child to asymptomatic bacteriuria or to urinary tract infection. Occasionally, the labial fusion causes urinary outflow obstruction with resultant bladder distention and hydronephrosis.

• #74 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?jid=jgmg

  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. […] We observed the stepwise development of acute urinary retention, urinary tract infection, urocolpos, post micturition dribble, and involuntary urine loss in this case over a five-year period. […] In conclusion, labial fusion in postmenopausal women is a multifactorial condition.

• #75 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 adhesions, especially in adult women, can have a significant negative impact on a person’s sexual health and well-being. […] 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. […] 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. […] Topical medicines are used to help the labia separate and to lessen irritation.

• #76 Labial Fusion Causing Coital and Voiding Difficulty in a Young Woman

  https://www.scirp.org/html/2-1990022_27128.htm

  In adults including postmenopausal women, LF is more associated with recurrent urinary tract infections, vulvovaginitis, genital trauma, hypoestrogenism and lack of sexual activity. […] Topical estrogen cream is generally accepted as the initial therapy for superficial labial adhesions which may reduce the irritation of the vaginal mucous membranes and ease subsequent repair particularly in prepubertal girls and postmenopausal women. […] Surgery should become the first option for treatment, in patients with complete, thick adhesions and a long history of LF. […] Although it is a rare event, LF should be considered in the differential diagnosis of the patients presenting with sexual dysfunction.

• #77 :: 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. […] Clues for the diagnosis of LS in this case, where the lesions of both conditions where overlapping, includes dyspareunia, pruritus and fusion of the labia, which are indicative of a scarring condition and should prompt to perform a biopsy.

• #78 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 adhesions, especially in adult women, can have a significant negative impact on a person’s sexual health and well-being. […] 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. […] 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. […] Topical medicines are used to help the labia separate and to lessen irritation.

• #79 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 adhesions, especially in adult women, can have a significant negative impact on a person’s sexual health and well-being. […] 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. […] 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. […] Topical medicines are used to help the labia separate and to lessen irritation.

• #80 Labial Fusion Causing Coital and Voiding Difficulty in a Young Woman

  https://www.scirp.org/html/2-1990022_27128.htm

  Adhesions of the labia are extremely rare in the reproductive population with only a few cases described in the literature. […] Labial fusion (LF) is defined as partial or complete adhesion of the labia minora and estimated to occur in 0.6% – 5% of prepubertal girls. […] Vaginal inflammation—irritation, hypoestrogenism, local trauma, lack of sexual activity, female circumcision, vaginal lacerations in childbirth and recurrent urinary tract infections are formerly reported as the contributing factors for LF in adults. […] Labial fusion (LF), a state of partial or complete adhesion of the labia minora, generally occur in children or post-menopausal women, but is extremely rare in reproductive ages. […] The relative hypoestrogenic environment is suggested as the main predisposing factor of this disorder in prepubertal girls.

• #81 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 adhesions, especially in adult women, can have a significant negative impact on a person’s sexual health and well-being. […] 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. […] 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. […] Topical medicines are used to help the labia separate and to lessen irritation.

• #82 Labial Fusion Causing Coital and Voiding Difficulty in a Young Woman

  https://www.scirp.org/html/2-1990022_27128.htm

  In adults including postmenopausal women, LF is more associated with recurrent urinary tract infections, vulvovaginitis, genital trauma, hypoestrogenism and lack of sexual activity. […] Topical estrogen cream is generally accepted as the initial therapy for superficial labial adhesions which may reduce the irritation of the vaginal mucous membranes and ease subsequent repair particularly in prepubertal girls and postmenopausal women. […] Surgery should become the first option for treatment, in patients with complete, thick adhesions and a long history of LF. […] Although it is a rare event, LF should be considered in the differential diagnosis of the patients presenting with sexual dysfunction.

• #83 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 may be due to oestrogen deficiency, particularly in non-sexually active women after the menopause. […] 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.

• #84 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #85 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #86 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 may be due to oestrogen deficiency, particularly in non-sexually active women after the menopause. […] 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.

• #87 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #88 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. […] A major factor contributing to adult labial adhesions is a lack of estrogen, a hormone that is essential for vulvar tissue flexibility and health. […] Chronic inflammatory skin disorders can contribute to the development of labial adhesions. […] Any type of injury or trauma to the vaginal region has the potential to cause tissue disruption, scarring, and adhesions. […] Repeated infections in the genital area can lead to inflammation, discomfort, and eventually adhesions. […] Extended contact with irritants can cause tissue damage and ongoing inflammation in the vulvar region. […] Certain autoimmune conditions can cause lesions, scarring, and inflammation in the genital area, increasing the risk of labial adhesions.

• #89 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 may be due to oestrogen deficiency, particularly in non-sexually active women after the menopause. […] 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.

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

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

  Labial adhesions also may be found during another low estrogen stage, the postmenopausal stage. In this stage, due to the low estrogen, the genital area is susceptible to irritation and inflammation, which may lead to adhesion. […] The first line in management is reassurance since most of the labial adhesions resolve spontaneously within one year. […] 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 with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty.

• #91 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. […] Labial adhesion (LA) is the fusion of the labia minora or majora, and it is mostly located near the clitoris. […] It has been suggested that chronic inflammation from infection, poor perineal hygiene, or trauma can erode the epithelium of the labia minora. In association with minimal estrogen in prepubertal females, it may facilitate adhesion of the labia minora. […] 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.

• #92 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. […] Labial adhesion (LA) is the fusion of the labia minora or majora, and it is mostly located near the clitoris. […] It has been suggested that chronic inflammation from infection, poor perineal hygiene, or trauma can erode the epithelium of the labia minora. In association with minimal estrogen in prepubertal females, it may facilitate adhesion of the labia minora. […] 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.

• #93 Labial Adhesion in a Pubertal Girl—A Commonly Misdiagnosed Entity: A Case Report

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/23933/JPJ/fullText

  All symptomatic adhesions require treatment with medications or surgery along with meticulous hygiene. […] The indications for surgical treatment of labial adhesions include failed medical therapy dense adhesions without a visible transparent raphe accompanied by symptoms. […] In our patient surgical separation was planned in view of thick adhesions. […] Recurrence rates range between 11% and 14%.

• #94 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. […] The exact cause of this condition is unknown, but it’s believed to happen when there are low levels of a hormone called estrogen. […] Labial adhesions may also occur during menopause, another period of low estrogen in a woman’s life. […] Labial adhesions can be treated in several ways. […] When treatment is needed, it often involves applying a cream that contains estrogen directly to the affected area. […] Surgical intervention is usually considered after trying topical treatments, and recurrence rates range from 11% to 14% with either topical or surgical treatments.

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

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

  In our review of patient records, we found that 26 patients achieved complete opening after one course of oestrogen treatment. […] A recurrence rate of 12-14 % is also reported. […] Arguments put forward in favour of surgical treatment are that it may be more effective than oestrogen and that it avoids hormonal side effects. […] Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. […] If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. […] 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. […] 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.

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

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

  Labial adhesions also may be found during another low estrogen stage, the postmenopausal stage. In this stage, due to the low estrogen, the genital area is susceptible to irritation and inflammation, which may lead to adhesion. […] The first line in management is reassurance since most of the labial adhesions resolve spontaneously within one year. […] 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 with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty.

• #97 Patient suffering from lichen sclerosus together with partial labial fusion (adhesion) and inflammatory infection of the vulva, vagina and anal area

  https://www.imrpress.com/journal/CEOG/47/2/10.31083/j.ceog.2020.02.5167/htm

  If there are clinical symptoms (indicating genital inflammations, urinary tract infections and/or difficulties in urination), the optimal treatment is local estrogenotherapy, which results in spontaneous separation of the labia (follow-up after 2-4 weeks). The recommended topical estrogens are 0.01% estradiol and estriol. Once the treatment is finished, as prophylactic actions one should maintain personal hygiene, use emollients and neutral ointments containing vitamin A, D and fatty acids, among others, to prevent labial fusion (adhesion) once more. Unfortunately, regardless of the method of treatment, frequent recurrences of the symptoms are observed (about 10-15% of cases).

• #98 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. […] The primary contributing factor to labial fusion is low estrogen levels. A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.

• #99 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. […] What causes labial adhesions? […] But labial adhesions may relate to low estrogen levels. […] Girls have low estrogen levels before they start puberty. […] In adults, labial adhesions may develop shortly after childbirth or after menopause. […] Labial adhesions often go away on their own when your child reaches puberty and starts producing estrogen.

• #100 Labial Fusion – narikaa.com

  https://narikaa.com/article/gynaecology-disorders/vaginal-disorders/labial-fusion/

  Labial fusion is a condition where the two flaps of skin on either side of the opening to the vagina, also known as the labia minora are joined or fused together forming a shiny membrane of inflammatory tissue. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals, as it is common in the nappy years. […] Poor genital hygiene plays the most important role in chronic inflammation. […] A labial fusion or adhesion usually separates naturally without treatment when puberty is reached. […] However, recurrence may occur if good hygiene measures are not followed. […] It does not affect the childs menstruation, fertility, or sexual life in the future.

• #101 Labial adhesions | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/labial-adhesions

  The cause of labial adhesions is thought to be irritation to the labia minora: for example, poor hygiene, strongly perfumed soaps and inflammatory conditions like vulvitis. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals. […] Low oestrogen levels (hypo-oestrogenism) are also thought to contribute to the development of labial adhesions. […] The outer skin surface (squamous epithelial layer) of the labia minora is thin and delicate. Irritation and inflammation can cause the outer skin to become exposed and raw. The two raw lips then heal together in much the same way as any skin cut might heal. […] Labial adhesions are more common during the nappy years. […] The condition resolves during puberty because the effect of the female hormone oestrogen changes the cells that line the genitals.

• #102 Labial fusion

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

  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. […] While doctors are not sure exactly how labial fusion occurs, it often seems to happen following an infection in the vulval area, such as vulvovaginitis, or after minor trauma, like a injury from horse riding. […] Yes. After the labia have separated, which in most cases happens on its own by puberty, there will be no lasting damage to the labia. Your daughter will be able to menstruate without problems, and her future fertility and ability to have sexual intercourse will not be affected.

• #103 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 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). […] 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. […] 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.

• #104 Labial fusion

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

  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. […] While doctors are not sure exactly how labial fusion occurs, it often seems to happen following an infection in the vulval area, such as vulvovaginitis, or after minor trauma, like a injury from horse riding. […] Yes. After the labia have separated, which in most cases happens on its own by puberty, there will be no lasting damage to the labia. Your daughter will be able to menstruate without problems, and her future fertility and ability to have sexual intercourse will not be affected.

• #105 What Is a Labial Fusion?

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

  Trauma to the vaginal area can also lead to labial fusions, as trauma often leads to inflammation of the affected area. […] When a woman is breastfeeding, her body often experiences an increase in serum prolactin. This leads to a hypo-estrogenic state in the woman’s body, meaning she is experiencing lower levels of estrogen. After childbirth, this lower level of estrogen coupled with edema or trauma to the vaginal area can lead to labial fusions. […] Labial fusions often heal on their own with little intervention needed from doctors and medications. […] Since low estrogen levels are a primary cause of susceptibility to skin irritation and infections in women and children, introducing an estrogen topical cream into your or your child’s daily routine may help alleviate labial fusion symptoms. […] In extreme cases, surgery is offered as treatment. This is most often the case in instances where labial fusion is preventing urination or causing infections. […] Labial fusions are not linked to other medical conditions and have not proven to have long-term effects on those who recover.

• #106 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 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). […] 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. […] 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.

• #107 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Causes Of labial adhesion in PrePubertal Girls Exact cause is uncertain Microtraumas like overcleaning causing mechanical mucosal injury of the perineum == Lead to adhesion of labia minora […] The most common causes of labial adhesion in adult women (PostPartum, PostMenopausal) Oestrogen deficiency associated with atrophic vaginitis […] Symptoms Labial adhesions are usually asymptomatic […] Signs Labial fusion is diagnosed by visual inspection […] Spontaneous resolution 50% in cases within 6 months 90% in cases within 12 months 100% in cases within 18 months […] If there are no symptoms and no problems in urinating, the doctor might want to wait for the girl to reach puberty and start to produce estrogen […] Leaving labial fusion alone is the safest and most effective treatment.

• #108 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

  Diagnosis is made on physical examination which shows the fused labia minora with or without the involvement of labia majora. The typical appearance is a flat appearing genitalia and a midline vertical translucent membrane which can be thin and fragile or thick and dense. […] 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. […] Recurrent labial fusion is a difficult situation both for the patient and for the treating gynecologist. It is not uncommon reported to occur in 11-14%. It can be seen after treatment in all age groups and after all forms of treatment.

• #109 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Causes Of labial adhesion in PrePubertal Girls Exact cause is uncertain Microtraumas like overcleaning causing mechanical mucosal injury of the perineum == Lead to adhesion of labia minora […] The most common causes of labial adhesion in adult women (PostPartum, PostMenopausal) Oestrogen deficiency associated with atrophic vaginitis […] Symptoms Labial adhesions are usually asymptomatic […] Signs Labial fusion is diagnosed by visual inspection […] Spontaneous resolution 50% in cases within 6 months 90% in cases within 12 months 100% in cases within 18 months […] If there are no symptoms and no problems in urinating, the doctor might want to wait for the girl to reach puberty and start to produce estrogen […] Leaving labial fusion alone is the safest and most effective treatment.

• #110 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Causes Of labial adhesion in PrePubertal Girls Exact cause is uncertain Microtraumas like overcleaning causing mechanical mucosal injury of the perineum == Lead to adhesion of labia minora […] The most common causes of labial adhesion in adult women (PostPartum, PostMenopausal) Oestrogen deficiency associated with atrophic vaginitis […] Symptoms Labial adhesions are usually asymptomatic […] Signs Labial fusion is diagnosed by visual inspection […] Spontaneous resolution 50% in cases within 6 months 90% in cases within 12 months 100% in cases within 18 months […] If there are no symptoms and no problems in urinating, the doctor might want to wait for the girl to reach puberty and start to produce estrogen […] Leaving labial fusion alone is the safest and most effective treatment.

• #111 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

  Diagnosis is made on physical examination which shows the fused labia minora with or without the involvement of labia majora. The typical appearance is a flat appearing genitalia and a midline vertical translucent membrane which can be thin and fragile or thick and dense. […] 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. […] Recurrent labial fusion is a difficult situation both for the patient and for the treating gynecologist. It is not uncommon reported to occur in 11-14%. It can be seen after treatment in all age groups and after all forms of treatment.

• #112 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. […] The primary contributing factor to labial fusion is low estrogen levels. A vulva with low estrogen exposure, such as that of a preadolescent, has delicate epithelial lining and is therefore vulnerable to irritation. Conditions causing irritation, such as infection, inflammation and trauma, cause the edges of the labia minora to fuse together. The fusion typically begins at the posterior frenulum of the labia minora and continues anteriorly. […] Most labial adhesions resolve spontaneously before puberty as estrogen levels increase and the vaginal epithelium becomes cornified.

• #113 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #114 Labial Adhesion in a Pubertal Girl—A Commonly Misdiagnosed Entity: A Case Report

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/23933/JPJ/fullText

  Labial adhesion is a gynecological condition where adhesion of labia minora occurs in the midline. […] Hypoestrogenism and inflammation are usually considered as a cause of labial adhesion. […] Labial adhesion is the partial or complete fusion of labia minora in the midline and is usually asymptomatic. […] Recurrence is a common problem in labial adhesions. […] Labial adhesion is thought to develop during the re-epithelization of microtraumatized hypoestrogenism labial skin, vulvovaginitis, and poor local hygiene. […] Hypoestrogenism may also not be the cause in our case as she had attained menarche and had her secondary sexual characters developed. […] Diagnosis is by inspection of the vulva. […] Time and again, clinical examination proved to be critical. […] Asymptomatic adhesions need no treatment.

• #115 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. […] The etiology of labial fusion in the reproductive or postmenopausal age group is unknown. Labial fusion can be caused by infection, trauma to the genitalia, or chronic inflammation resulting in low serum estrogen levels. […] 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. […] A low serum estrogen level is the basic cause of labial adhesions. Physiologic hypoestrogenism, together with chronic inflammation in the vulvar skin and mucosa, leads to labial adhesions with subsequent partial or total obstruction of the vagina and/or the urethra.

• #116 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 fact, an endoscopic examination made it possible to confirm the precise anatomic structures and relationships beyond the adhesions. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] 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.

• #117 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. […] The etiology of labial fusion in the reproductive or postmenopausal age group is unknown. Labial fusion can be caused by infection, trauma to the genitalia, or chronic inflammation resulting in low serum estrogen levels. […] 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. […] A low serum estrogen level is the basic cause of labial adhesions. Physiologic hypoestrogenism, together with chronic inflammation in the vulvar skin and mucosa, leads to labial adhesions with subsequent partial or total obstruction of the vagina and/or the urethra.

• #118 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 fact, an endoscopic examination made it possible to confirm the precise anatomic structures and relationships beyond the adhesions. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] 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.

• #119 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 fact, an endoscopic examination made it possible to confirm the precise anatomic structures and relationships beyond the adhesions. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] 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.

• #120 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. […] The reasons why labial adhesions occur are not known, but we do believe that estrogen may play a role. […] A chronic inflammatory process as the result of fecal soiling, vulvovaginitis, eczema or dermatitis can also play a role in the development of the adhesion. […] 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.

• #121 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Labial agglutination (Adhesion) or fused labia It is defined as the partial to complete fusion of the labia minora (or labia majora). In which the opposing epithelial surfaces of labia minora stick together without any union of deeper tissues […] Labial fusion is almost never present at birth, usually develops around one to two years of age. Labial adhesions are usually an innocent finding and a trivial problem, are a common finding in the girls. Usually, this condition is asymptomatic spontaneously disappears during adolescence but its importance is that it is frequently misdiagnosed as congenital absence of the vagina […] Labial adhesion is relatively common, but the condition is little known among doctors and parents. It is a source of great paternal anxiety And are commonly misdiagnosed or unnecessary investigations may be ordered

• #122 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #123 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 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. Associated ambiguous genitalia, vaginal agenesis, hypoplastic kidney and microperforate hymen can be seen in congenital labial fusion. 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. Worldwide incidence is not known. It is reported to occur in 12% of females aged 3 months to 6 years in the United States. […] 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.

• #124 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Labial agglutination (Adhesion) or fused labia It is defined as the partial to complete fusion of the labia minora (or labia majora). In which the opposing epithelial surfaces of labia minora stick together without any union of deeper tissues […] Labial fusion is almost never present at birth, usually develops around one to two years of age. Labial adhesions are usually an innocent finding and a trivial problem, are a common finding in the girls. Usually, this condition is asymptomatic spontaneously disappears during adolescence but its importance is that it is frequently misdiagnosed as congenital absence of the vagina […] Labial adhesion is relatively common, but the condition is little known among doctors and parents. It is a source of great paternal anxiety And are commonly misdiagnosed or unnecessary investigations may be ordered

• #125 :: 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. […] Clues for the diagnosis of LS in this case, where the lesions of both conditions where overlapping, includes dyspareunia, pruritus and fusion of the labia, which are indicative of a scarring condition and should prompt to perform a biopsy.

• #126 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 silver wire probe and uterine sound should be gently inserted into the various canals under general anesthesia in order to identify each opening prior to making an incision into the labia. […] 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.

• #127 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Labial agglutination (Adhesion) or fused labia It is defined as the partial to complete fusion of the labia minora (or labia majora). In which the opposing epithelial surfaces of labia minora stick together without any union of deeper tissues […] Labial fusion is almost never present at birth, usually develops around one to two years of age. Labial adhesions are usually an innocent finding and a trivial problem, are a common finding in the girls. Usually, this condition is asymptomatic spontaneously disappears during adolescence but its importance is that it is frequently misdiagnosed as congenital absence of the vagina […] Labial adhesion is relatively common, but the condition is little known among doctors and parents. It is a source of great paternal anxiety And are commonly misdiagnosed or unnecessary investigations may be ordered

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

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

  Labial adhesions also may be found during another low estrogen stage, the postmenopausal stage. In this stage, due to the low estrogen, the genital area is susceptible to irritation and inflammation, which may lead to adhesion. […] The first line in management is reassurance since most of the labial adhesions resolve spontaneously within one year. […] 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 with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty.

• #129 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 arises in infants when there is very little circulating oestrogen hormone (American spelling estrogen). It is thought the adhesion occurs after local irritation by urine, scratching or uncomfortable underwear (contact irritant dermatitis), or after urinary infection. […] If treatment is necessary, oestrogen cream may be prescribed to apply to the labia and is usually successful. At first a small amount is applied once daily for 2-4 weeks. Once the labia are separated, oestrogen cream can usually be stopped and replaced by an emollient cream for a few months. In some girls, oestrogen cream may need to be applied intermittently (perhaps once or twice weekly) until puberty is established. […] Surgery may be required to divide severe fibrous adhesion using local anaesthetic cream or under general anaesthesia. Oestrogen cream is usually prescribed afterwards to prevent the labia sticking together again.

• #130 What Is a Labial Fusion?

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

  Trauma to the vaginal area can also lead to labial fusions, as trauma often leads to inflammation of the affected area. […] When a woman is breastfeeding, her body often experiences an increase in serum prolactin. This leads to a hypo-estrogenic state in the woman’s body, meaning she is experiencing lower levels of estrogen. After childbirth, this lower level of estrogen coupled with edema or trauma to the vaginal area can lead to labial fusions. […] Labial fusions often heal on their own with little intervention needed from doctors and medications. […] Since low estrogen levels are a primary cause of susceptibility to skin irritation and infections in women and children, introducing an estrogen topical cream into your or your child’s daily routine may help alleviate labial fusion symptoms. […] In extreme cases, surgery is offered as treatment. This is most often the case in instances where labial fusion is preventing urination or causing infections. […] Labial fusions are not linked to other medical conditions and have not proven to have long-term effects on those who recover.

• #131 Patient suffering from lichen sclerosus together with partial labial fusion (adhesion) and inflammatory infection of the vulva, vagina and anal area

  https://www.imrpress.com/journal/CEOG/47/2/10.31083/j.ceog.2020.02.5167/htm

  If there are clinical symptoms (indicating genital inflammations, urinary tract infections and/or difficulties in urination), the optimal treatment is local estrogenotherapy, which results in spontaneous separation of the labia (follow-up after 2-4 weeks). The recommended topical estrogens are 0.01% estradiol and estriol. Once the treatment is finished, as prophylactic actions one should maintain personal hygiene, use emollients and neutral ointments containing vitamin A, D and fatty acids, among others, to prevent labial fusion (adhesion) once more. Unfortunately, regardless of the method of treatment, frequent recurrences of the symptoms are observed (about 10-15% of cases).

• #132 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. […] The reasons why labial adhesions occur are not known, but we do believe that estrogen may play a role. […] A chronic inflammatory process as the result of fecal soiling, vulvovaginitis, eczema or dermatitis can also play a role in the development of the adhesion. […] 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.

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

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

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

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

  Labial adhesions also may be found during another low estrogen stage, the postmenopausal stage. In this stage, due to the low estrogen, the genital area is susceptible to irritation and inflammation, which may lead to adhesion. […] The first line in management is reassurance since most of the labial adhesions resolve spontaneously within one year. […] 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 with labial adhesions, regardless of the mode of treatment used. Labial adhesions may keep reforming until the female patient goes through puberty.

• #135 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 arises in infants when there is very little circulating oestrogen hormone (American spelling estrogen). It is thought the adhesion occurs after local irritation by urine, scratching or uncomfortable underwear (contact irritant dermatitis), or after urinary infection. […] If treatment is necessary, oestrogen cream may be prescribed to apply to the labia and is usually successful. At first a small amount is applied once daily for 2-4 weeks. Once the labia are separated, oestrogen cream can usually be stopped and replaced by an emollient cream for a few months. In some girls, oestrogen cream may need to be applied intermittently (perhaps once or twice weekly) until puberty is established. […] Surgery may be required to divide severe fibrous adhesion using local anaesthetic cream or under general anaesthesia. Oestrogen cream is usually prescribed afterwards to prevent the labia sticking together again.

• #136 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 arises in infants when there is very little circulating oestrogen hormone (American spelling estrogen). It is thought the adhesion occurs after local irritation by urine, scratching or uncomfortable underwear (contact irritant dermatitis), or after urinary infection. […] If treatment is necessary, oestrogen cream may be prescribed to apply to the labia and is usually successful. At first a small amount is applied once daily for 2-4 weeks. Once the labia are separated, oestrogen cream can usually be stopped and replaced by an emollient cream for a few months. In some girls, oestrogen cream may need to be applied intermittently (perhaps once or twice weekly) until puberty is established. […] Surgery may be required to divide severe fibrous adhesion using local anaesthetic cream or under general anaesthesia. Oestrogen cream is usually prescribed afterwards to prevent the labia sticking together again.

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

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

• #138

  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. […] It is caused by the midline fusion of the labia minora, and it is usually asymptomatic; it is commonly first noticed by mothers during a regular physical examination by a doctor. […] Although labial adhesions are normally asymptomatic, they can cause postvoid dribbling or vaginal voiding, which is linked to a urinary tract infection, as well as discomfort when the bladder is evacuated. […] The use of 0.05% betamethasone cream as a topical therapy has shown to be effective. […] There is a scarcity of data on the use of mometasone cream as a topical treatment for labial adhesions. […] Mometasone is a synthetic topical glucocorticoid receptor (GR) agonist with anti-inflammatory, antipruritic, and vasoconstrictive properties. Mometasone cream is a potent topical corticosteroid. It is used in inflammatory skin conditions such as severe eczema and dermatitis.

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

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

• #140

  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. […] It is caused by the midline fusion of the labia minora, and it is usually asymptomatic; it is commonly first noticed by mothers during a regular physical examination by a doctor. […] Although labial adhesions are normally asymptomatic, they can cause postvoid dribbling or vaginal voiding, which is linked to a urinary tract infection, as well as discomfort when the bladder is evacuated. […] The use of 0.05% betamethasone cream as a topical therapy has shown to be effective. […] There is a scarcity of data on the use of mometasone cream as a topical treatment for labial adhesions. […] Mometasone is a synthetic topical glucocorticoid receptor (GR) agonist with anti-inflammatory, antipruritic, and vasoconstrictive properties. Mometasone cream is a potent topical corticosteroid. It is used in inflammatory skin conditions such as severe eczema and dermatitis.

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

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

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

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

  In our review of patient records, we found that 26 patients achieved complete opening after one course of oestrogen treatment. […] A recurrence rate of 12-14 % is also reported. […] Arguments put forward in favour of surgical treatment are that it may be more effective than oestrogen and that it avoids hormonal side effects. […] Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. […] If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. […] 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. […] 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.

• #143

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

  Regarding the mechanism of action, mometasone cream being steroid in nature, attaches to cytoplasmic glucocorticoid receptors (GRs), the receptor and mometasone complex translocate into the nucleus, where the gene expression for various anti-inflammatory proteins is induced. This is done through inducing the lipocortin/annexin I (ANXA 1) levels. […] 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.

• #144 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

  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. […] Labial fusion is difficult for patients to detect by themselves. […] In conclusion, labial fusion in postmenopausal women is a multifactorial condition.

• #145 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 silver wire probe and uterine sound should be gently inserted into the various canals under general anesthesia in order to identify each opening prior to making an incision into the labia. […] 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.

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

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

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

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

• #148 Labial adhesion | PPT

  https://www.slideshare.net/slideshow/labial-adhesion/168021134

  Surgical technique Surgery was performed under general anaesthesia Adhesions were incised sharply and the cut edges were reapproximated with 7-0 chromic. […] Adhesion tend to recur […] 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.

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

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

  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.

• #150 Labial Fusion (Adhesion on Genital Lips)

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

  Lichen sclerosis is an autoimmune disease which can cause itching in the genital area, thinning of the skin, sometimes bleeding, and serious adhesions over time. […] There are different opinions about labial fusion treatment in infancy and childhood. […] Surgical methods are considered in the first line for the treatment of genital adhesions during menopause. […] Early diagnosis and treatment of patients with labial fusion and genital adhesions are important.

• #151 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

  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. […] Labial fusion is difficult for patients to detect by themselves. […] In conclusion, labial fusion in postmenopausal women is a multifactorial condition.

• #152 Patient suffering from lichen sclerosus together with partial labial fusion (adhesion) and inflammatory infection of the vulva, vagina and anal area

  https://www.imrpress.com/journal/CEOG/47/2/10.31083/j.ceog.2020.02.5167/htm

  If there are clinical symptoms (indicating genital inflammations, urinary tract infections and/or difficulties in urination), the optimal treatment is local estrogenotherapy, which results in spontaneous separation of the labia (follow-up after 2-4 weeks). The recommended topical estrogens are 0.01% estradiol and estriol. Once the treatment is finished, as prophylactic actions one should maintain personal hygiene, use emollients and neutral ointments containing vitamin A, D and fatty acids, among others, to prevent labial fusion (adhesion) once more. Unfortunately, regardless of the method of treatment, frequent recurrences of the symptoms are observed (about 10-15% of cases).

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

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

  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.

• #154 Labial Fusion – narikaa.com

  https://narikaa.com/article/gynaecology-disorders/vaginal-disorders/labial-fusion/

  Labial fusion is a condition where the two flaps of skin on either side of the opening to the vagina, also known as the labia minora are joined or fused together forming a shiny membrane of inflammatory tissue. […] The exact cause is unknown, but it is strongly suspected that labial adhesions are caused by irritation to the external genitals, as it is common in the nappy years. […] Poor genital hygiene plays the most important role in chronic inflammation. […] A labial fusion or adhesion usually separates naturally without treatment when puberty is reached. […] However, recurrence may occur if good hygiene measures are not followed. […] It does not affect the childs menstruation, fertility, or sexual life in the future.

• #155 Patient suffering from lichen sclerosus together with partial labial fusion (adhesion) and inflammatory infection of the vulva, vagina and anal area

  https://www.imrpress.com/journal/CEOG/47/2/10.31083/j.ceog.2020.02.5167/htm

  If there are clinical symptoms (indicating genital inflammations, urinary tract infections and/or difficulties in urination), the optimal treatment is local estrogenotherapy, which results in spontaneous separation of the labia (follow-up after 2-4 weeks). The recommended topical estrogens are 0.01% estradiol and estriol. Once the treatment is finished, as prophylactic actions one should maintain personal hygiene, use emollients and neutral ointments containing vitamin A, D and fatty acids, among others, to prevent labial fusion (adhesion) once more. Unfortunately, regardless of the method of treatment, frequent recurrences of the symptoms are observed (about 10-15% of cases).

• #156 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

  Manual labia separation under local anesthesia may be done in mild situations when all other therapies have failed. […] Labial adhesions can be prevented from recurring by practicing proper hygiene and avoiding irritants. […] Labial adhesions must be regularly monitored by a healthcare professional in order to detect and treat any recurrence. […] To identify the underlying reasons and pursue proper treatment, it is imperative to comprehend the situations that lead to adult labial adhesions.

• #157 Labial fusion

  https://www.menopausematters.co.uk/forum/index.php?topic=69997.0

  Hi everyone, new poster here. I was wondering if anyone else is dealing with labial fusion along with LS and has any tips or meds to recommend? I’m two weeks out from my third operation to reopen my labia, I’m currently checking it twice daily in the mirror to stop it from sticking back together – which is making me very sore. […] For the fusion I’ve been prescribed Estradiol cream 3x weekly and advised to use vaseline in between, as well as using dilators. […] I also read that sometimes fusion is due to VA, not LS, although I was itchy enough that I’m fairly certain LS is an issue for me, though VA is in the mix too for sure. […] I do feel for you. It’s a horrible condition. I bet there’s loads of older women who didn’t get any treatment. […] during washing I try to massage my labia to stop fusing.

• #158 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. […] There is no definite cause of labial adhesions other than low levels of estrogen, which is normal for girls in early childhood, particularly prior to puberty. […] In most cases labial adhesions disappear within a year after diagnosis without any treatment. […] Due to a lack of estrogen, labial adhesions can occur more than once until a child reaches puberty. […] 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.

• #159 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

  Manual labia separation under local anesthesia may be done in mild situations when all other therapies have failed. […] Labial adhesions can be prevented from recurring by practicing proper hygiene and avoiding irritants. […] Labial adhesions must be regularly monitored by a healthcare professional in order to detect and treat any recurrence. […] To identify the underlying reasons and pursue proper treatment, it is imperative to comprehend the situations that lead to adult labial adhesions.

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

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

  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.

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

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

  The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] Immunohistochemical and histological research has demonstrated that the amount of androgen receptors in the labia minora, labia majora, and vestibule is higher than that of estrogen receptors. […] The effect of androgen receptor activation is associated with cell proliferation, differentiation, metabolism, and apoptosis, as well as protein secretion in various tissues in both men and women. […] 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.

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

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

  The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] Immunohistochemical and histological research has demonstrated that the amount of androgen receptors in the labia minora, labia majora, and vestibule is higher than that of estrogen receptors. […] The effect of androgen receptor activation is associated with cell proliferation, differentiation, metabolism, and apoptosis, as well as protein secretion in various tissues in both men and women. […] 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.

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

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

  The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] Immunohistochemical and histological research has demonstrated that the amount of androgen receptors in the labia minora, labia majora, and vestibule is higher than that of estrogen receptors. […] The effect of androgen receptor activation is associated with cell proliferation, differentiation, metabolism, and apoptosis, as well as protein secretion in various tissues in both men and women. […] 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.

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

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

  The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] Immunohistochemical and histological research has demonstrated that the amount of androgen receptors in the labia minora, labia majora, and vestibule is higher than that of estrogen receptors. […] The effect of androgen receptor activation is associated with cell proliferation, differentiation, metabolism, and apoptosis, as well as protein secretion in various tissues in both men and women. […] 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.

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

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

  The low serum estradiol levels detected in infants between 3 months and 5 years old can potentially explain the higher frequency of labial fusion during these age ranges. […] In our opinion, neither of these two theories fully explains the etiology of labial adhesions, and the role of androgens should also be taken into consideration. […] Immunohistochemical and histological research has demonstrated that the amount of androgen receptors in the labia minora, labia majora, and vestibule is higher than that of estrogen receptors. […] The effect of androgen receptor activation is associated with cell proliferation, differentiation, metabolism, and apoptosis, as well as protein secretion in various tissues in both men and women. […] 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.

• #166 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. […] The etiology of labial fusion in the reproductive or postmenopausal age group is unknown. Labial fusion can be caused by infection, trauma to the genitalia, or chronic inflammation resulting in low serum estrogen levels. […] 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. […] A low serum estrogen level is the basic cause of labial adhesions. Physiologic hypoestrogenism, together with chronic inflammation in the vulvar skin and mucosa, leads to labial adhesions with subsequent partial or total obstruction of the vagina and/or the urethra.

• #167 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 fact, an endoscopic examination made it possible to confirm the precise anatomic structures and relationships beyond the adhesions. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] 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.

• #168 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 fact, an endoscopic examination made it possible to confirm the precise anatomic structures and relationships beyond the adhesions. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] 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.

• #169 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 fact, an endoscopic examination made it possible to confirm the precise anatomic structures and relationships beyond the adhesions. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] 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.

• #170 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 silver wire probe and uterine sound should be gently inserted into the various canals under general anesthesia in order to identify each opening prior to making an incision into the labia. […] 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.

• #171 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 fact, an endoscopic examination made it possible to confirm the precise anatomic structures and relationships beyond the adhesions. […] The significance of this case is that it is the first report of labial adhesions in which an endoscopic examination facilitated safe surgical treatment. […] 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.

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

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

  In our review of patient records, we found that 26 patients achieved complete opening after one course of oestrogen treatment. […] A recurrence rate of 12-14 % is also reported. […] Arguments put forward in favour of surgical treatment are that it may be more effective than oestrogen and that it avoids hormonal side effects. […] Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. […] If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. […] 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. […] 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.

• #173 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 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). […] 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. […] 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.

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

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

  In our review of patient records, we found that 26 patients achieved complete opening after one course of oestrogen treatment. […] A recurrence rate of 12-14 % is also reported. […] Arguments put forward in favour of surgical treatment are that it may be more effective than oestrogen and that it avoids hormonal side effects. […] Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. […] If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. […] 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. […] 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.

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

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

  In our review of patient records, we found that 26 patients achieved complete opening after one course of oestrogen treatment. […] A recurrence rate of 12-14 % is also reported. […] Arguments put forward in favour of surgical treatment are that it may be more effective than oestrogen and that it avoids hormonal side effects. […] Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. […] If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. […] 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. […] 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.

• #176 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 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). […] 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.

• #177 Labial Adhesion in a Pubertal Girl—A Commonly Misdiagnosed Entity: A Case Report

  https://www.jsafog.com/abstractArticleContentBrowse/JSAFOG/23933/JPJ/fullText

  All symptomatic adhesions require treatment with medications or surgery along with meticulous hygiene. […] The indications for surgical treatment of labial adhesions include failed medical therapy dense adhesions without a visible transparent raphe accompanied by symptoms. […] In our patient surgical separation was planned in view of thick adhesions. […] Recurrence rates range between 11% and 14%.

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

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

  In our review of patient records, we found that 26 patients achieved complete opening after one course of oestrogen treatment. […] A recurrence rate of 12-14 % is also reported. […] Arguments put forward in favour of surgical treatment are that it may be more effective than oestrogen and that it avoids hormonal side effects. […] Today there is a consensus that asymptomatic children with labial adhesion do not require treatment. […] If a child is believed to be experiencing symptoms as a result of labial adhesion, opening of the adhesion may be considered. […] 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. […] 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.

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