Labial adhesions

Specialty of Paediatric urology

What are labial adhesions?

Labial adhesions (also called labial fusion) are where the labia (the “lips” of the vagina) stick together. This usually occurs in the labia minora (the inner labia). In some cases, this condition can seal the opening of the vagina, leaving only a small gap for urine to pass through. Labial adhesions are fairly common in girls under the age of seven and usually resolve on their own.

What are the causes of labial adhesions?

The cause is not 100% clear, but labial adhesions is usually associated with vaginitis (irritation or inflammation of the area around the vagina). The inner lips of the vulva become sticky and without the hormone oestrogen to regulate this, they may stay stuck together, becoming joined.

The problem rarely occurs after puberty, as oestrogen production begins, although in rare cases, it occurs in adult women with low oestrogen levels.

Treatments for labial adhesions

Labial adhesions generally do not require treatment, separating naturally. Treatment is usually only recommended if related symptoms, such as urinary dribbling, are causing problems or affecting the patient’s quality of life.

Treatment may come in the form of:

  • Oestrogen cream – applied daily for 4-6 weeks until the membrane dissolves and the labia separate. The cream can cause side-effects, such as irritation and discolouration of the skin, but these should disappear after the course of treatment is complete and the patient stops applying the cream.
  • Surgical separation – used in severe cases, or if oestrogen cream does not work. It is a relatively simple procedure performed under general or local anaesthetic.

There is a good chance that the problem will return after either treatment, and to this end, it is recommended to apply an emollient to the labia in the weeks after treatment to help them heal and reduce the chances of another adhesion.

Which type of specialist treats labial adhesions?

Labial adhesions are typically treated by paediatric urologists, as they are most commonly found in children. In the rare case of an adult having the condition, they may be treated by a gynaecologist and/or urologist.

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