Labial Adhesions

The mother of a 1-year-old girl observed that for 1 week her child seemed to be uncomfortable during the night and when she urinated.

Urinalysis was normal with no white blood cells, and urine culture revealed no growth, reports Robert P. Blereau, MD of Morgan City, La. The examination identified labial adhesions; a tiny opening at the top of the introitus allowed urine to exit. The labia minora were fused down to the fourchette.

Labial adhesions occur occasionally in infants and are usually asymptomatic. The adhesions may be associated with the hypoestrogenic state and with local inflammation, which may be attributed to urine pooling in the vagina. Urinary tract infections often arise.

The adhesions lysed following 3 weeks of nightly applications of a conjugated estrogens vaginal cream. Use of petrolatum for an additional 1 to 2 months can help prevent recurrence. Because of the pain and psychological trauma, mechanical separation of the adhesions is not recommended.