Research Article
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Retrospective evaluation of labial fusion in girls

Year 2022, Volume: 5 Issue: 3, 746 - 749, 30.05.2022
https://doi.org/10.32322/jhsm.1054226

Abstract

Aim: The aim of this study was to determine the factors affecting fusion in girls treated for labial fusion retrospectively over a three-year period.
Material and Method: The research has a cross-sectional design. The research sample consists of girls with ICD10 code Q52.5 who were brought to the hospital with labial fusion symptoms in a three-year period (January 2018-December 2020). The data were obtained from the hospital information system. Variables that were effective in labial fusion recurrence were determined by Chi-Square analysis, and the marginal effects of effective variables on recurrence were analyzed by Poison Regression analysis.
Results: 52.9% of 308 cases were younger than one year old (mean age 4.36±1.10 months). Symptom presentation is 10.4% in children younger than one year of age, and 84.83% in older. The most commonly presented symptoms are pain, burning, soiling of underwear, and bad odor during urination. Labial fusion recurrence is 14.1% in children younger than one year of age, and 62.8% in older. Manual opening was applied in all cases, and weekly follow-ups were performed with topical treatment. The Poison Regression analysis revealed that a history of allergy (1.31 times; z:3.61, p:0.000), winter (0.86 times; z:3.22, p:0.001), and diaper dermatitis (1.22 times; z:5.19, p:0.000) increased the number of labial fusion recurrence.
Conclusion: The findings of our study are similar to the literature in terms of factors causing labial fusion and treatment type. The recurrence rate was found to be higher in our study. It should be kept in mind that labial fusion is asymptomatic, especially in girls in the first year of life. Considering the possibility of recurrence of labial fusion, mothers and physicians examining the child should be aware of this issue.

Supporting Institution

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Project Number

none

Thanks

Prof Dr Hatice Şahin

References

  • Dowlut-McElroy T, Higgins J, Williams KB, Strickland JL. Treatment of prepubertal labial adhesions: a randomized controlled trial. J Pediatr Adolesc Gynecol 2019; 32: 259-63.
  • Huseynov M, Hakalmaz AE. Labial adhesion: new classification and treatment protocol. J Pediatr Adolesc Gynecol 2020; 33: 343-8.
  • Gonzalez D, Anand S, Mendez MD. Labial Adhesions. [Online]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 January. Available from: HYPERLINK "https://www.ncbi.nlm.nih.gov/books/NBK470461/" https://www.ncbi.nlm.nih.gov/books/NBK470461/.
  • Chang SJ, Tsai LP, Hsu CK, Yang SS. Elevated postvoid residual urine volume predicting recurrence of urinary tract infections in toilet-trained children. Pediatr Nephrol 2015; 30: 1131-7.
  • Leung AK, Robson WL, Tay-Uyboco J. The incidence of labial fusion in children. J Paediatr Child Health 1993; 29: 235-6.
  • Vilano SE, Robbins CL. Common prepubertal vulvar conditions. Curr Opin Obstetr Gynecol 2016; 28: 359-365.
  • Schober J, Dulabon L, Martin-Alguacil N, Kow LM, Pfaff D. Significance of Topical Estrogens to Labial Fusion and Vaginal Introital Integrity. J Pediatr Adolesc Gynecol 2006; 19: 337-9.
  • Mayoglou L, Dulabon L, Martin-Alguacil N, Pfaff D, Schober J. Success of treatment modalities for labial fusion: a retrospective evaluation of topical and surgical treatments. J Pediatr Adolesc Gynecol 2009; 22: 247-50.
  • Myers JB, Sorensen CM, Wisner BP, Furness PD, Passamaneck M, Koyle MA. Betamethasone cream for the treatment of pre-pubertal labial adhesions. J Pediatr Adolesc Gynecol 2006; 19: 407-11.
  • Kumetz LM, Quint EH, Fisseha S, Smith YR. Estrogen treatment success in recurrent and persistent labial agglutination. J Pediatr Adolesc Gynecol 2006; 19: 381-4.
  • Soyer T. Topical Estrogen Therapy in Labial adhesions in children: therapeutic or prophylactic? J Pediatr Adolesc Gynecol 2007; 20: 241-44.
  • Bacon JL, Romano ME, Quint EH. Clinical recommendation: labial adhesion. J Pediatr Adolesc Gynecol 2015; 28: 405-9.
  • Wejde E, Ekmark AN, Stenström P. Treatment with oestrogen or manual separation for labial adhesions-initial outcome and long-term follow-up. BMC Pediatr 2018; 18-104.
  • Acer T, Otgün I, Oztürk O, et al. Do hygienic factors affect labial fusion recurrence? A search for possible related etiologic factors. J Pediatr Surg 2012; 47: 1913-18.
  • Mingin GC, Hinds A, Nguyen HT, Baskin LS. Children with a febrile urinary tract infection and a negative radiologic workup: factors predictive of recurrence. Urology 2004; 63: 562-65.
  • Bacon JL. Prepubertal labial adhesions: Evaluation of a referral population. Am J Obstet Gynecol 2002; 187: 327-32.
  • Muram D. Treatment of prepubertal girls with labial adhesions. J Pediatr Adolesc Gynecol 1999; 12: 67-70.
  • Azarfar A, Ravanshad Y, Bagheri S, Esmaeeli M, Nejad MM. Labial adhesion and bacteriuria. J Turk Ger Gynecol Assoc 2015; 16: 68-9.
  • Melek E, Kılıçbay F, Sarıkaş NG, Bayazıt AK. Labial adhesion and urinary tract problems: The importance of genital examination. Journal of Pediatric Urology 2016; 12: 111.e1-5.
  • Kumetz LM, Quint EH, Fisseha S, Smith YR. Estrogen treatment success in recurrent and persistent labial agglutination. J Pediatr Adolesc Gynecol 2006; 19: 381-4.
  • Berkowitz CD, Elvik SL, Logan MK. Labial fusion in prepubescent girls: A marker for sexual abuse? Am J Obstetr Gynecol 1987; 156: 16-20.
Year 2022, Volume: 5 Issue: 3, 746 - 749, 30.05.2022
https://doi.org/10.32322/jhsm.1054226

Abstract

Project Number

none

References

  • Dowlut-McElroy T, Higgins J, Williams KB, Strickland JL. Treatment of prepubertal labial adhesions: a randomized controlled trial. J Pediatr Adolesc Gynecol 2019; 32: 259-63.
  • Huseynov M, Hakalmaz AE. Labial adhesion: new classification and treatment protocol. J Pediatr Adolesc Gynecol 2020; 33: 343-8.
  • Gonzalez D, Anand S, Mendez MD. Labial Adhesions. [Online]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 January. Available from: HYPERLINK "https://www.ncbi.nlm.nih.gov/books/NBK470461/" https://www.ncbi.nlm.nih.gov/books/NBK470461/.
  • Chang SJ, Tsai LP, Hsu CK, Yang SS. Elevated postvoid residual urine volume predicting recurrence of urinary tract infections in toilet-trained children. Pediatr Nephrol 2015; 30: 1131-7.
  • Leung AK, Robson WL, Tay-Uyboco J. The incidence of labial fusion in children. J Paediatr Child Health 1993; 29: 235-6.
  • Vilano SE, Robbins CL. Common prepubertal vulvar conditions. Curr Opin Obstetr Gynecol 2016; 28: 359-365.
  • Schober J, Dulabon L, Martin-Alguacil N, Kow LM, Pfaff D. Significance of Topical Estrogens to Labial Fusion and Vaginal Introital Integrity. J Pediatr Adolesc Gynecol 2006; 19: 337-9.
  • Mayoglou L, Dulabon L, Martin-Alguacil N, Pfaff D, Schober J. Success of treatment modalities for labial fusion: a retrospective evaluation of topical and surgical treatments. J Pediatr Adolesc Gynecol 2009; 22: 247-50.
  • Myers JB, Sorensen CM, Wisner BP, Furness PD, Passamaneck M, Koyle MA. Betamethasone cream for the treatment of pre-pubertal labial adhesions. J Pediatr Adolesc Gynecol 2006; 19: 407-11.
  • Kumetz LM, Quint EH, Fisseha S, Smith YR. Estrogen treatment success in recurrent and persistent labial agglutination. J Pediatr Adolesc Gynecol 2006; 19: 381-4.
  • Soyer T. Topical Estrogen Therapy in Labial adhesions in children: therapeutic or prophylactic? J Pediatr Adolesc Gynecol 2007; 20: 241-44.
  • Bacon JL, Romano ME, Quint EH. Clinical recommendation: labial adhesion. J Pediatr Adolesc Gynecol 2015; 28: 405-9.
  • Wejde E, Ekmark AN, Stenström P. Treatment with oestrogen or manual separation for labial adhesions-initial outcome and long-term follow-up. BMC Pediatr 2018; 18-104.
  • Acer T, Otgün I, Oztürk O, et al. Do hygienic factors affect labial fusion recurrence? A search for possible related etiologic factors. J Pediatr Surg 2012; 47: 1913-18.
  • Mingin GC, Hinds A, Nguyen HT, Baskin LS. Children with a febrile urinary tract infection and a negative radiologic workup: factors predictive of recurrence. Urology 2004; 63: 562-65.
  • Bacon JL. Prepubertal labial adhesions: Evaluation of a referral population. Am J Obstet Gynecol 2002; 187: 327-32.
  • Muram D. Treatment of prepubertal girls with labial adhesions. J Pediatr Adolesc Gynecol 1999; 12: 67-70.
  • Azarfar A, Ravanshad Y, Bagheri S, Esmaeeli M, Nejad MM. Labial adhesion and bacteriuria. J Turk Ger Gynecol Assoc 2015; 16: 68-9.
  • Melek E, Kılıçbay F, Sarıkaş NG, Bayazıt AK. Labial adhesion and urinary tract problems: The importance of genital examination. Journal of Pediatric Urology 2016; 12: 111.e1-5.
  • Kumetz LM, Quint EH, Fisseha S, Smith YR. Estrogen treatment success in recurrent and persistent labial agglutination. J Pediatr Adolesc Gynecol 2006; 19: 381-4.
  • Berkowitz CD, Elvik SL, Logan MK. Labial fusion in prepubescent girls: A marker for sexual abuse? Am J Obstetr Gynecol 1987; 156: 16-20.
There are 21 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Article
Authors

Ahmet Hikmet Şahin 0000-0002-9134-9800

Murat Sabri Yılmaz 0000-0003-3196-1157

Project Number none
Publication Date May 30, 2022
Published in Issue Year 2022 Volume: 5 Issue: 3

Cite

AMA Şahin AH, Yılmaz MS. Retrospective evaluation of labial fusion in girls. J Health Sci Med / JHSM. May 2022;5(3):746-749. doi:10.32322/jhsm.1054226

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