It's not a subject frequently talked about in parenting circles. Rest assured though, labial adhesions are common, rarely uncomfortable, easily treatable, and will usually resolve even without treatment. Even though the condition looks worrisome, it need not be a cause for concern. A few simple tips will help you navigate this situation and help you avoid some common mistakes.
What is it?
Usually, the lips of skin surrounding the entrance to the vagina are separate, with a clear opening in between. In some girls, the labia grow together and block the opening partially or even completely.
By far the most common form of vaginal obstruction in little girls is fusion of the labia minora because of labial adhesions. The biggest concern with labial adhesions is that they can predispose girls to repeated urinary tract infections.
Who gets it?
Labial adhesions are typically diagnosed in girls from 6 months to 6 years of age.
Urine, stool, diaper rash, infections, irritants, or mechanical trauma commonly cause chronic inflammation of the labia. Occasionally the inflammation is the result of chronic sexual abuse.
Whatever the cause, as the labia try to heal, fibrous tissue adheres the labia to each other. Some girls are prone to forming adhesions no matter how careful the parents are.
What are the symptoms?
The adhesions result in a smooth membrane over the vulvar opening with a thin, pale line at the center. This surface membrane usually starts forming at the rear of the opening and 'zippers' closed toward the front. Usually, a sufficient opening at the front remains to permit urine and vaginal secretions to exit.
Is it contagious?
How long does it last?
The adhesions will often resolve spontaneously when girls are out of diapers or pull-ups both day and night. When labial adhesions persist, the estrogen surge at puberty will correct the problem.
With treatment, the adhesions will disappear quickly, often within one week.
How is it diagnosed?
Adhesions are usually diagnosed based on the physical exam. Throughout their course, the adhesions should be followed by your pediatrician. If they do not respond to therapy, or if they were truly present at birth, further evaluation is indicated to look for other, far less common, abnormalities of the genitourinary system.
How is it treated?
If there are no complications, such as infections or obstruction, the adhesions do not need to be treated.
Never attempt to separate the labia forcefully. This is painful and traumatic. Moreover, it usually results in even worse adhesions than before.