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Ask A Specialist: Management of Labial Adhesions in Prepubertal Girls

Ask A Specialist: Management of Labial Adhesions in Prepubertal Girls 1024 680 Geri Hewitt, MD

What is the appropriate management of asymptomatic and symptomatic labial adhesions in a prepubertal girl?

The management of labial adhesions has really evolved over time.

The most important thing is to make sure you have the correct diagnosis and it’s not some other problem with the vagina opening. Labial adhesions are isolated (not associated with other problems) and self-limited (resolve with time).

Asymptotic adhesions require no intervention. There is no evidence of increased risk of urinary tract infection (UTI), as once thought.

If the patient is symptomatic (for example, post-void dribbling, spraying urine with voiding or making toilet training tough), topical estrogen or betamethasone along with sits baths is the preferred therapy. Avoid mechanical or surgical separation if possible.

For more information about labial adhesions, including when to refer to pediatric and adolescent gynecology, download the practice tool for providers.

Download the Practice Tool

Image credit: iStock

About the author

Geri D. Hewitt, MD

Geri D. Hewitt, MD, is chief of the Section of Obstetrics and Gynecology at Nationwide Children’s Hospital and a professor of Clinical Obstetrics in the Departments of Obstetrics and Gynecology and Pediatrics at The Ohio State University College of Medicine. Dr. Hewitt's primary interests are caring for the gynecologic and reproductive health needs for young girls as well as adolescents. Dr. Hewitt is an examiner for the American Board of Obstetrics and Gynecology. Dr. Hewitt is a Fellow of the American College of Obstetricians and Gynecologists and a co-editor for the Journal of Pediatric and Adolescent Gynecology Tips for Clinicians section.

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