{"id":1541,"date":"2021-02-11T11:38:58","date_gmt":"2021-02-11T08:38:58","guid":{"rendered":"https:\/\/dregemeneroglu.com\/kiz-cocuklarinda-labial-yapisikliklar-tedavi-edilmeli-mi\/"},"modified":"2021-02-11T11:47:46","modified_gmt":"2021-02-11T08:47:46","slug":"kiz-cocuklarinda-labial-yapisikliklar-tedavi-edilmeli-mi","status":"publish","type":"post","link":"https:\/\/dregemeneroglu.com\/en\/kiz-cocuklarinda-labial-yapisikliklar-tedavi-edilmeli-mi\/","title":{"rendered":"Should we treat labial adhesions in girls?"},"content":{"rendered":"
My little girl patient, who was brought with the complaint of urinary incontinence, was<\/span>
\nsitting opposite me with her head down. As I dig deeper into her story, I learn that she<\/span>
\ndoesn’t have incontinence at night, she urinates at regular intervals during the day, but her<\/span>
\npanties get wet after each urine.<\/span>
\nWe doctors often diagnose the disease at the stage of talking with the patient. I guess what<\/span>
\ncan happen in my mind, as I question my patient and deepen my anamnesis. As a matter<\/span>
\nof fact, I see that the labia are almost completely adhered while doing the examination.<\/span><\/h5>\n
Labial adhesion is a problem seen in about one in thirty girls. The structures that make up<\/span>
\nthe female external genital organ are called “vulva” in our language. Babies have the<\/span>
\noestrogen hormone that comes from their mothers when they are first born. Over time, this<\/span>
\nhormone disappears, and they go through a period of low oestrogen until the young<\/span>
\nmaiden period begins and secretes their own hormones. During this period, exposure of<\/span>
\nthe vulva to continuous damage due to diaper rash, poor hygiene, sensitivity to cleaning<\/span>
\nmaterials, and skin tissue prone to allergies is considered among the causes of labial<\/span>
\nadhesion.<\/span>
\nOne of my professor friend used to say “meticulous mother’s disease”. Of course, mothers<\/span>
\ntrying to scrape the area thoroughly to clean is also a cause of damage.<\/span><\/h5>\n
In the end, although the cause is not known exactly, it is necessary to know that it is not a<\/span>
\ncongenital pathology, an important information for private insurances. During the injury of<\/span>
\nthe vulva, the epithelium on the small lips is damaged, while it heals again, it can heal by<\/span>
\nsticking to the opposite lip, and then a vascular membrane is formed between both small<\/span>
\nlips. This is what we call labial adhesion, labial fusion or labial adhesion.<\/span><\/h5>\n
Most children do not show any symptoms, as natural oestrogen increases in adolescence,<\/span>
\nit can pass by itself. Sometimes it can cause problems, especially if it is much closed. In a<\/span>
\nstudy where we examined the files of 120 children, most of the children didn’t report any<\/span>
\ncomplaints, and were brought under routine paediatrician supervision or in the bathroom<\/span>
\nby parents noticing. On the other hand, some patients had itching, rash, urinary tract<\/span>
\ninfection and genital discharge in the genital area. 13% of the patients had complaints of<\/span>
\ndripping after urination and panties getting wet, like the little girl I described in previously.<\/span>
\nI already stated that in eight of ten patients, it may disappear spontaneously. Of those that<\/span>
\ndisappeared, four out of ten can reoccur. So don’t be surprised if you witness that it<\/span>
\nhappened to your daughter, then disappeared and then happened again.<\/span><\/h5>\n
When and how do we treat?<\/span>
\nOur approach in treatment is as follows: If there is less than 50% adhesion, we send the<\/span>
\npatient back to the family by explaining the importance of hygiene and care without harm.<\/span>
\nIf there is more than 50% of the adhesion and especially the complaints I have just<\/span>
\nmentioned, we try to open it more conservatively with local creams before manually<\/span>
\nopening it. Because in any case, they can relapse after treatment.<\/span><\/p>\n

What creams do we give?<\/span>
\nTraditionally oestrogen creams are used. If it is applied too much, side effects such as<\/span>
\ndarkening of the external genital organ, hair growth, and enlargement of the breasts may<\/span>
\noccur. Therefore, some people choose to use steroid creams. However, their long-term<\/span>
\nside effects are unknown. In a study that we conducted with 131 patients, we could not<\/span>
\nfind a significant difference between both. But when the two are used together, the<\/span>
\nefficiency is more. We use it together in the cases that do not heal easily and recur<\/span>
\nconstantly. We tell the family how much to apply and how long to use it for. We definitely<\/span>
\napply petroleum jelly or moisturizing creams to save time for the healing of the area.<\/span><\/h5>\n

What if we can’t cure it with local care?<\/span>
\nWhatever we do, it can stick again, so maintenance is very important.\u00a0If creams can’t solve the issue, we, as a paediatric surgeons, open it manually. We apply a local anaesthetic cream on young children, wait for a while and then separate the adhesion in polyclinic conditions; in the slightly older ones, due to the sensitivity of the region, we can easily give a smell of<\/span>
\n\u00a0gas in the operating room and do the procedure under general anesthesia.<\/span><\/h5>\n
In conclusion, it is a problem that you need not to get afraid about and it can go away on its own. In cases that require treatment, the priority is local treatment. If local treatment cannot be performed or is not effective, surgery steps in.<\/span><\/h5>\n
We have come to the end of another course. As always, you can find the links to our<\/span>
\narticles I mentioned in the blog below.<\/span>
\n\u00a0<\/span><\/h5>\n
Please continue to direct our course with your questions and comments. If you want to watch our video, please visit our youtube channel<\/span><\/strong><\/span><\/a>. Subscribe to our channel, click like button if you like our video, follow us on Instagram.<\/span><\/span><\/strong><\/a><\/span><\/h5>\n
And stay happy.<\/span><\/h5>\n
Manual separation, topical vaseline and estrogen in labial adhesions<\/span><\/strong><\/span><\/a><\/h5>\n
How Should We Treat Prepubertal Labial Adhesions? Retrospective Comparison of Topical Treatments: Estrogen Only, Betamethasone Only, and Combination Estrogen and Betamethasone<\/span><\/strong><\/span><\/a><\/span><\/h5>\n
<\/h5>\n","protected":false},"excerpt":{"rendered":"

My little girl patient, who was brought with the complaint of urinary incontinence, was sitting opposite me with her head down. As I dig deeper into her story, I learn that she doesn’t have incontinence at night, she urinates at regular intervals during the day, but her panties get wet after each urine. We doctors […]<\/p>\n","protected":false},"author":2,"featured_media":1532,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[],"class_list":["post-1541","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog-en"],"yoast_head":"\nShould we treat labial adhesions in girls? - Prof. Dr. Egemen Ero\u011flu<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dregemeneroglu.com\/en\/kiz-cocuklarinda-labial-yapisikliklar-tedavi-edilmeli-mi\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Should we treat labial adhesions in girls? - Prof. Dr. Egemen Ero\u011flu\" \/>\n<meta property=\"og:description\" content=\"My little girl patient, who was brought with the complaint of urinary incontinence, was sitting opposite me with her head down. 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