Sticking with genital issues in young children, this week is about labial adhesions.

First, let’s talk anatomy.

In the area called the vulva (the diaper area in infant girls) if a baby is on her back, first there is the clitoris, then the area where urine comes out (urethral opening), the vaginal opening, and then finally the anus (where they poop).  To the sides are two sets of fleshy flaps called labia.  The thinner set, which is closer to the urethral and vaginal openings is the minora, and the thicker outer set is the majora.     

What are labial adhesions?

Labial adhesions are when the labia minora stick together.  Most of the time only part of it is stuck rather than along the whole length, but either way they are not easily separated.  It tends to happen under 5 years old, and can affect about 5% of little girls.     

What causes labial adhesions?

We think it’s caused mostly by chronic irritation from things like poor hygiene, infections, parasites, irritating diapers or underwear. 

How are they treated?

Treatment of labial adhesions depends on how much of the labia is stuck together.  If there is only a small area that doesn’t block urine flow or cause any other problems, then it can be left alone.  It will most likely resolve itself in the next year, or when estrogen levels start rising before puberty.  

If the adhesions block urine, cause urinary tract infections or pain, then they can be treated.  Often applying an estrogen cream twice a day for several days is all that is needed to fix it.  Occasionally, however, that doesn’t work, and the labia have to be separated forcefully.  Obviously this sort of procedure will hurt, so make sure it’s done by a pediatrician or urologist.  After treating adhesions it’s a good idea to treat the area with vaseline while it’s healing so the labia don’t get stuck together again.

How can labial adhesions be prevented?

Decreasing irritation to the area as much as possible is the best way to prevent labial adhesions.  This can be done by things like cleaning well but not using harsh soaps, keeping the area dry, and using breathable underwear when potty trained.

Bottom line.

Labial adhesions sometimes happen in little girls.  Most of the time they don’t cause trouble.  If they do, see your pediatrician.

Links.

Labial adhesions at healthychildren.org.