Labial Adhesions

In normal female anatomy, the labia, or lips of skin that surround the opening to the vagina, are separated. Sometimes the inner lips of a girl’s vagina (labia minora) become fused together. While rare, this condition occurs in some 1-2% of girls under the age of six years. While this condition may look worrisome to you as a parent, it usually causes little trouble for your child and resolves on its own.

In some cases, however, the labia fuses together to cover the opening of the urethra, which can block the flow of urine and trap urine in the genital area. This can cause irritation and even infection and may be referred to a pediatric urology specialist.

Causes of Labial Adhesion

In some cases, labial adhesion occurs when your daughter’s labia becomes irritated. This can happen from prolonged exposure to wet or soiled diapers or even from a skin reaction to certain detergents. A lack of the female hormone estrogen, which diminishes in babies after three months of age, can also play a role in the development of adhesion.

Some things parents can do to help prevent labial adhesion include:

• Change your baby’s diaper often to ensure the genital area says dry.
• Use a baby ointment or diaper cream after every diaper change to prevent rash and irritation.
• Use detergents and soaps that are free of irritants such as perfumes and dyes, which can irritate a baby’s delicate skin.

Treating Labial Adhesion

If you notice that your daughter’s inner lips or labia are stuck together, do not try to pull the labia apart, as this may be painful. The best thing to do is to bring this to the attention of your pediatrician, who may refer you to pediatric urologist for further evaluation. At Chesapeake Urology for Children, our specialists will examine your daughter and determine the extent of the adhesion. In cases where the labia are not blocking the urethral opening and urine can flow freely, it may be recommended to leave the labia alone as the issue may resolve over time and typically will not cause any problem for your child.

If the adhesion is trapping urine in the genital area and there is significant irritation or discharge, we may prescribe treatment with:

• Estrogen cream – This is the most common treatment for labial adhesion. The cream is applied directly to the affected labia minora for two to three weeks. After this time, the hormone will separate the tissues and open the labia. After treatment with estrogen cream, you should continue to apply an ointment such as petroleum jelly to reduce recurrence of the adhesion. There is often a very high recurrence rate but to a lesser degree that allows observation until resolution at puberty.
• Steroid cream – This is an alternative to estrogen cream. While slightly less effective, steroid creams do not have any risk of skin discoloration or other systemic effects after long-term use.

In very rare cases, the labial adhesion will be thick and tightly fused. In these cases, your doctor will attempt to separate the labia under appropriate anesthesia. The majority of cases of labial adhesion do not cause pain or problems for your child and will resolve and reopen on its own with the onset of puberty.

This issue is not uncommon. You have the resources and experience of Chesapeake Urology for Children on your side to care for the health of your child.