Labial Adhesions, Pediatric

The labia minora are the two small folds of skin inside the entrance to the birth canal (vagina). Labial adhesions occur when the inner surfaces of the labia attach to each other. This is a common problem in girls under the age of 6 years. This usually goes away by itself, when your child reaches puberty. Your child may need treatment only when severe adhesions cause:

  • Difficulty in passing urine.

  • Repeated urine infections.

Your child's future fertility, menstrual cycle, and sexual functions are not affected by this problem.

CAUSES

The normally low levels of the female hormone estrogen in girls before puberty may lead to this problem. It can also be due to irritation in the vaginal area. Healing of the irritated labia can cause them to temporarily stick together. Irritants include:

  • Urine.

  • Feces.

  • Soaps or wipes which contain strong perfumes.

  • Bubble bath.

  • Infection of the skin in the area.

  • Pinworms.

  • Injury to the labia.

SYMPTOMS

Usually, there will be no symptoms, but sometimes a child has:

  • Soreness in the external genital organ of females (vulva).

  • Dribbling urine after going to the toilet.

  • Inability to pass urine. This is uncommon. It happens when the labia are stuck together along their entire length

DIAGNOSIS

Labial adhesions can be diagnosed during physical examination.

TREATMENT

Labial adhesions are usually harmless and do not need treatment. They usually resolve when your child reaches puberty. Treatment is necessary if:

  • Adhesions are severe.

  • Your child has difficulty passing urine.

  • Your child gets bladder infections.

If treatment is needed, the different methods include:

  • Application of estrogen cream to the area where the skin folds are attached to each other. The cream is usually applied once or twice daily for up to 8 weeks. After this treatment, to prevent the labia from sticking again, it is best to:

  • Keep the area clean and dry.

  • Avoid irritating soaps, bubble bath and wipes.

  • Apply petroleum jelly or zinc oxide to the area after bathing.

  • Surgery is rarely needed to separate the attached skin folds. After surgery, care of the area is similar to that noted above. This care will help prevent the labia from sticking together again as they heal.

HOME CARE INSTRUCTIONS

  • Change diapers more often to help limit irritation.

  • After passing urine and stools, wipe your child's genital area from front to back to prevent the stool from coming into contact and irritating the genital area. Teach this wiping method to older children who wipe themselves.

  • Clean the diaper area using plain water.

  • Avoid using soaps containing strong perfumes.

  • Bathe your child in plain water. Do not use bubble bath.

  • Wash your child's genital area daily and dry it using a soft towel.

  • Apply mild ointments like petroleum jelly or zinc oxide to the separated skin fold area. This prevents the condition from recurring.

SEEK MEDICAL CARE IF:

  • The labia remain attached together even after applying estrogen cream for the recommended time.

  • The labia become stuck together again

  • Your child complains of pain when urinating.

  • Your child begins wetting the bed again even though she has been previously dry at night

  • Your child has daytime urine accidents even though she was potty trained before.

  • You have other worries or questions.

  • There is inflammation of the vulva.

SEEK IMMEDIATE MEDICAL CARE IF:

  • Your child feels that she has to pass urine and cannot do so.

  • Your child develops severe abdominal (belly) pain or unexplained fever.