Abstract
Study Objective
Standard treatment for girls with labial fusion has included topical estrogen cream,
manual separation, or surgery. Side effects may limit the use of topical estrogen.
Betamethasone has recently shown efficacy at separating labial fusion. Local irritation
and inflammation may be an initiator of labial fusion. No adverse effects of betamethasone
treatment have been documented. Long-term side effects are unknown. This study compares
therapies for conservative management of labial fusion for efficacy and focuses on
the response rate, time to separation, recurrence, and side effects of treatment.
Design
A retrospective chart review.
Participants
One hundred fifty-one prepubertal girls, mean age 3 years (range 0.25-8.75 years)
diagnosed with labial fusion.
Main Outcome Measures
To investigate the incidence of related symptoms, length of topical estrogen or betamethasone
treatment, side effects, rate of successful separation, rates of recurrence, percentage
requiring surgery, and postoperative outcomes in patients with labial adhesion who
underwent treatment.
Results
Of 151 patients with labial adhesion, 11 (7.3%) presented with urinary frequency,
30 (19.9%) with urinary tract infections, 13 (8.6%) with vaginitis, and 19 (12.6%)
with post-void dripping. When compared to patients treated with betamethasone (1.3
months), patients treated primarily with premarin took nearly twice as long (2.2 months)
for resolution of their adhesions. Rates of recurrence were lower for patients receiving
betamethasone therapy. Side effects for estrogen therapy included breast budding and
vaginal bleeding, and for betamethasone, local irritation was reported. Some patients
went on to surgery and experienced recurrence after surgery.
Conclusion
Initial comparison of topical estrogen and betamethasone treatment of labial fusion
suggests that betamethasone may separate fusion quicker with less recurrence and fewer
side effects than topical estrogen therapy.
Key Words
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Article info
Identification
Copyright
© 2009 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.
