Labial adhesions, also known as fused labia, is a condition where the labia minora (the inner "lips" of the vulva) stick together, partially or completely, instead of forming two separate folds. This condition primarily affects young girls befor puberty. It is relatively common, especially in infants and toddlers.
- Causes: The exact cause of labial adhesions isn't always clear. It's believed to result from irritation or inflammation of the labia minora, which can be caused by factors such as poor hygiene, diaper use, frequent irritation, infection, or hormonal changes.
- Symptoms: Labial adhesions may not always cause symptoms, especially if they're mild. However, when symptoms occur, they may include difficulty urinating, urinary tract infections (UTIs), discomfort or pain while urinating, or recurrent urinary tract infections. In some cases, the adhesions may be discovered during a routine physical examination without any symptoms at all.
- Diagnosis: Diagnosis is made by physical examination.
- Treatment:
- Mild cases of labial adhesions may not require treatment, as they may resolve on their own over time, particularly after puberty when hormonal changes occur.
- Treatment options include topical estrogen cream or hydrocortisone cream to help promote separation of the labia.
- Estrogen can be absorbed and lead to traits commonly seen with the estrogen increase of puberty and is no longer the first choice.
- Hydrocortisone comes in mild over the counter strength, which is used for mild adhesions, and stronger presecription strength, which is used for more significant adhesions.
- In rare cases manual separation performed by a healthcare provider is needed. This generally is done if there are concerns for a urinary tract infection and the adhesions prevent catherization to collect urine for testing.
- Once open, applying diaper rash ointment or petrolatum jelly can help keep the labia from re-attaching.
- Prevention: While labial adhesions may not always be preventable, practicing good hygiene can help reduce the risk. This includes regular bathing and ensuring that the genital area is kept clean and dry, especially after using the toilet or during diaper changes. Avoiding harsh soaps or irritants in the genital area can also be beneficial.
- Prognosis: Labial adhesions often resolve spontaneously over time, especially as a girl enters puberty and experiences hormonal changes. With appropriate treatment, the prognosis is generally good, and most girls do not experience long-term complications from the condition.
