Paediatric Gynaecology

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Labial Adhesions

Labial adhesion is also known as a fused labia, and occurs when the inner lips of the labia minora have stuck together.

This is a common condition which, in most cases, resolves by itself during the onset of puberty without the need for medical treatment. Should treatment be required, it is often the application of oestrogen cream and surgery to separate the labia.

The condition will likely occur in girls aged one to two years and is most likely caused by irritation to the labia minora from poor hygiene and the introduction of faeces/urine, strong soaps, inflammatory conditions, atopic dermatitis or pinworms. Labial injuries and sexual abuse is also a suspected cause.

Symptoms may include:

  • The inner lips are joined together
  • The child is not experiencing pain
  • Mild vulval soreness, including after urinating
  • Dribbling urine after going to the toilet
  • In severe cases, there may be an inability to pass urine

The  condition is generally managed by monitoring symptoms and/or the application of oestrogen cream. If the adhesion is severe and interferes with urination, surgical separation is required.

Labial adhesions are known to recur despite successful treatment and may require long term care until puberty. This may include applying creams to the separated labia to prevent adhesion. If you child is still wearing nappies, changing them more frequently will assist with resolving the issue. Teaching your daughter the correct way to wipe her genitals will also reduce the chance of the condition recurring.

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Vulvovaginitis is inflammation or irritation of the vagina and vulva, and is a common paediatric gynaecology problem in young girls. It can occur many times during childhood and often gets better as girls develop breasts.

This common condition is brought on by moisture/dampness around the vulva, irritants such as soap residue or the fact that the lining of the vagina and vulva is quite thin and easily irritated. Treatment is generally non-invasive and focused on behavioural change. This includes wearing looser clothing, reducing weight (if the child is overweight/obese) and changing/reducing the use of soap in the bath or shower. Soothing creams such as paraffin and nappy rash cream can ease any pain as well as protect the skin from discharge.

Traditional symptoms of vulvovaginitis include:

  • Itching in the vaginal area
  • Vaginal discharge
  • Redness of the outer lips of the vagina (labia majora)
  • Burning or stinging while passing urine

Threadworms can sometimes cause or inflame vulvogaginitis. The strongest sign of threadworms is the presence of itching or scratching at night.

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