A girl with Labial Adhesions (Vulval Syncechiae)
A 1.5 year old girl was brought with complaints of dribbling of urine, pain while passing urine and redness near urinary opening. She was seen elsewhere and the parents were told that the child has an absent vagina.
On examination- the child had a condition called "Labial Adhesions" where the inner parts of skin of vulva get fused due to some local infection. This gives the false impression of absent vaginal opening. As the urine is not fully passed outside, this can lead to urinary infections and local infections.
A short procedure was performed in outpatient department and these adhesions were separated. Importance of keeping the area clean was stressed and a hormonal ointment was prescribed for local application. At 2 weeks follow-up, the child had normal looking vaginal opening and the parents were overjoyed.
Picture showing labial adhesions Picture taken after release of adhesions
About Labial Adhesions
Labial adhesions (or vulval synechiae) are a very common condition in young girls till the age of 5-6 years. In this condition the Labia Minora- or the inner labia, get fused to each other.
Girls with Labial adhesions come to clinical attention because of local irritation/ itching, urinary infections, post void urinary dribbling or sometime when severe with difficulty in passing urine. Labial adhesions may also impede urine flow and also may promote urine entry into vagina. Most of the time, the issues with labial adhesions are minor.
Diagnosis rests on clinical examination only.
Treatment is done by separation as an short Outpatient procedure plus application of estrogen ointment post procedure for 7-10 days. Minor labial adhesions can be managed by application of Vaseline jelly and separation with the help of an earbud at home by the mother. Perineal hygiene should be taught to the mothers.
Labial adhesions have a tendency to recur in about 10-20% of the cases.
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