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

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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.

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