Paediatric Genital Problems

Labial Adhesions

labial fusion

labial fusion with very small opening

anterior and posterior fusion of labia

Labial fusion

Labial fusion with very small opening

Anterior labial fusion

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.