Have you ever heard of a labial adhesion? Well I didn't till yesterday. My 2 and a half year old cried all day yesterday. We asked her what hurts, she just cried. I helpd her pretty much all day. She finally fell asleep on me around 1:00 p.m. She was sleeping sound and peacful when all of the sudden I felt something warm on my stomach leaking down to the chair. She was peeing all over me. I am thinking???? What is going on?? I said to my self she must have a bladder infection. Becasue she is potty trained and its like she didn't have any control, and the smell of it was so strong. She cryed off and on all afternoon. I was so worried We finally decided we were gonna take her to a new after hours clinic in the next town, I was not about to take her to the ER in our town. The after hours clinic has a pediatritian so this was my solution even if I had to drive 45 min. So I get there and she still crying in pain off and on. I discribed all this to the Dr. She looks in the ears nose and throat , all that stuff. Then she saiys lets take a look at her area,(Vagina) We put her on the table and of course she is crying, but we spread her legs and the Dr says there... see it there it closed?? I said closed ??? Whats closed?? She said her vagina. ??!!! Emotions came over me and I started to cry. She said its called a labial adhesion. Its when the lips fuse together. Thats why she has a UTI. Your vagina has lots of bacteria that cleans out every day and when it closed it keeps all that bacteria and it backs up into your urinart tract and bladder. Any ways I am still in shock. The Dr was supper sweet and gave us an antibiotic and a cream for her vagina. Primarin (estrogen) I was told its an ongoing battel till she hits puberty. I have so many overwhelming feelings,I am sa for her, this is gonna be so invasive for her, I am 29 and I just had a hysterectomy and all these female problems, and now my 2 year old has female problems its just so heart breaking! Is there anyone else out there that has a daughter with labial adhesions?? If so I would like to chat with you. Please moms check your little girls for this!! My baby girl was in so much pain yesterday and I had no clue. Off and on she complained that her Tee- tee hurt, but I just thought it was because she wasn't drining enough water and I knew she hopped off the potty a million times without wiping(she is so independent half the time we don't even know she goes). from now on I will follow her to the potty, and use the flushable wipes, and send some to daycare too. I am attaching info on it below. PLEASE VOTE THIS POST POPULAR SO THAT I CAN GET THIS AROUND so that all moms can check there little girls for this. They said that she will eventually out grow this but not till she hits puberty...That a long time for now we have many years of trying to prevent infections and reclosures! Wish us luck!
Labial adhesion, also referred to as labial agglutination, occurs in children when the inner vaginal lips (labia minora) fuse to each other. It often gives the appearance that the opening of the vagina has closed off. It may be noticed incidentally by a parent or by a physician during a medical examination, or the child may complain of irritation or difficulty urinating.
Because the fusion sometimes creates a little pouch in front of the vagina where urine can collect, some children experience dribbling when they stand up after urinating. Occasionally a child will get a bladder infection or will have difficulty passing urine due to the obstruction but most often labial adhesions are not significant enough to obstruct the flow of urine.
What causes labial adhesion?
Experts aren't completely sure why the lips fuse together. The most likely cause is that inflammation of the labia minora creates two raw surfaces at the edges of the lips, which eventually heal together in the middle, partly or fully covering the opening of the vagina.
Many factors can lead to inflammation and irritation of the vaginal lips. Exposure to irritants like fabric softener residue, perfumed soaps, or bits of stool; or a prolonged exposure to damp (as in wet diapers) all can cause irritation of the area. The lack of estrogen (which is normal before puberty) probably plays a role in this process.
When is treatment necessary?
Labial adhesions are commonly found in young girls between the ages of three months and six years. While experts used to think medical or surgical treatment was necessary, recent research has shown that cases involving adherence that is not obstructing the flow of urine usually resolve on their own over a period of 6 to 18 months.
However, even when treatment is used, the likelihood that the labial adhesions will recur is high. The best approach is to eliminate factors that lead to inflammation and then be patient. Active treatment may be most helpful if your child is getting bladder infections, is extremely bothered by dribbling after urination, or has difficulty passing urine.
Methods of treatment
When treatment is necessary, a small amount of estrogen cream, sold by prescription, can be gently rubbed onto the area of fusion twice a day. Using a cotton-tipped applicator can assist you as you also put a bit of pressure along the fusion line. This therapy should be combined with careful avoidance of irritants and a daily bath in plain water. The labia usually will separate by three to eight weeks.
Parents should be aware that some girls, and even infants, will experience a small amount of breast development during treatment with topical estrogen cream because the hormone can be absorbed into the blood stream. If this happens, consult your practitioner. It may be reassuring to know that the breast tissue usually goes away once the estrogen treatment is stopped.
If estrogen treatment is not fully successful by eight weeks, a topical anesthetic like xylocaine ointment or EMLA cream can be used in the office and the practitioner can gently tease apart the lips. Parents should be aware that some practitioners have been taught to manually separate the child's adhered vaginal lips in the office setting without pretreatment with estrogen or topical anesthesia. This should be avoided, since the raw edges inevitably re-adhere, and the procedure is quite painful.
Vulvar care measures combined with estrogen treatment when indicated is usually all that is needed. However, there have been reports of rare cases in which the labia totally heal together, forming a "skin bridge" that requires surgery.
Prevention of recurrence
After the labia separate, daily bathing in a tub of plain water, avoiding irritants, and treating the area with petrolatum or ointment usually prevents recurrence. Good vulvar hygiene does not mean that you need to scrub the vaginal area. Rather, it means avoiding irritants and trying to expose the area to some air every day. For a list of common irritants to avoid and other good hygiene measures, see our article "Vulvar Care".
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