Paediatric Genital Problems

Labial Adhesions

2% of girls aged 3 months to 6 years develop labial adhesions. They usually resolve spontaneously by puberty. Up to 40% of girls with labial adhesions develop urinary tract infections. Asymptomatic bacteriuria is present in 20%.

Spontaneous resolution is expected but if the fusion is severe, the use of oestrogen cream twice daily for 4 to 8 weeks will cause the labia to mature and separate. The oestrogen effects are short lived - pigmentation of the labia may occur but it resolves.

Obstructed urination with hydronephrosis is possible but rare from this condition.

It is differentiated from imperforate hymen, by the latter having normal labia, but no evident vaginal opening. This leads to retained menstrual products and an absent menarche.