Treatment of prepubertal girls with labial adhesions

Background: The purpose of this study was to evaluate the efficacy of topical estrogen therapy for the treatment of prepubertal girls with labial adhesions. Methods: This was a retrospective chart review at a pediatric and adolescent gynecology clinic in Memphis, Tennessee. Participants included 289 prepubertal girls who were referred for evaluation and treatment of labial adhesions. Interventions were gynecologic evaluation, topical estrogen, and manual and surgical labial separation. Main outcome measures were separation of labial adhesions and relief of symptoms. Results: The use of topical estrogen resulted in a separation of the fused labia in approximately half of patients. Separation with the patient under topical or general anesthesia was required in the remaining patients. Conclusions: Further intervention may be required in many patients with labial adhesions after topical therapy with estrogens. Patients with dense, fibrous adhesions and girls who have undergone previous surgical separation of the labia are less likely to respond to topical estrogen therapy.