II. Definition

  1. Labial Fusion
    1. Labia minora fuses in prepubescent girls, blocking the vaginal introitus

III. Pathophysiology

  1. Low level irritation of the labia minora
  2. Hypoestrogenized labial tissue

IV. Signs

  1. Labia minora fused, blocking the vaginal introitus
  2. Patient still able to urinate despite fusion

V. Management

  1. Avoid manually separating the fused labia (painful, and typically refuses)
  2. Practice good hygiene with daily baths and frequent diaper changes
  3. Apply daily, a small amount of Topical Estrogen cream to affected labia minora
    1. Premarin Cream
    2. Estrace Cream

VI. Course

  1. Expect the labia to separate within 2-3 weeks with Topical Estrogen and improved hygiene
  2. Expect some mild, transient local Estrogen effects (e.g. Hyperpigmentation, Vaginal Discharge)

VII. Prevention

  1. Practice good hygiene to area
  2. Apply vaseline to the area after the labia have separated to prevent repeat fusion

VIII. References

  1. Claudius and Willner in Herbert (2019) EM:Rap 19(1): 2-4

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