Abstract
Study Objective
Although various treatment options have been proposed for the treatment of labial
adhesions, there are currently no clearly outlined limits on the duration of topical
therapy, amount of lateral traction to apply, and methods to decrease the recurrence.
This clinical trial was undertaken to assess the need for estrogen for treatment of
prepubertal labial adhesions.
Design
Randomized, double-blinded, controlled trial.
Setting
Pediatric and Adolescent Gynecology Clinic at a children's hospital in a metropolitan
area.
Participants
Prepubertal girls ages 3 months to 12 years with labial adhesions.
Interventions
Lateral traction with topical estrogen or topical emollient.
Main Outcome Measures
The primary outcome was resolution of labial adhesions. The secondary outcome was
the change in severity of labial adhesions over time between the 2 groups.
Results
Forty-three girls were enrolled and 38 (88%) completed the study. The difference in
complete resolution between the topical emollient group (19%) and the topical estrogen
group (36%) was not statistically significant (P = .21). There was a statistically significant decrease in severity of labial adhesions
over time, with the magnitude of improvement favoring the topical estrogen group.
Conclusion
Although labial adhesion severity decreased when treated with lateral traction and
topical emollient or topical estrogen, the magnitude of the effect was significantly
greater for topical estrogen.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric and Adolescent GynecologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Treatment of prepubertal girls with labial adhesions.J Pediatr Adolesc Gynecol. 1999; 12: 67
- Appearance of the hymen in prepubertal girls.Pediatrics. 1993; 89: 387
- Adhesions of the labia minora.Obstet Gynecol. 1972; 39: 65
- Prepubertal labial adhesions: evaluation of a referral population.Am J Obstet Gynecol. 2002; 187: 327
- Significance of topical estrogens to labial fusion and vaginal introital integrity.J Pediatr Adolesc Gynecol. 2006; 19: 337
- Topical oestrogen therapy for labial adhesions in children.Br J Obstet Gynaecol. 1975; 82: 424
- Clinical recommendations: labial adhesions.J Pediatr Adolesc Gynecol. 2015; 28: 405
- Serum estradiol levels in infants with and without labial adhesions: the role of estrogen in the etiology and treatment.Pediatr Dermatol. 2007; 24: 373
- Labial adhesions in a girl with isolated premature thelarche: the importance of estrogenization.J Pediatr Adolesc Gynecol. 2003; 16: 31
- How should we treat prepubertal labial adhesions? Retrospective comparison of topical treatments: estrogen only, betamethasone only, and combination estrogen and betamethasone.J Pediatr Adolesc Gynecol. 2011; 24: 389
- Spontaneous resolution of labial adhesions in pre-pubertal girls.J Paediatr Child Health. 2018; 54: 748
- Treatment of labial fusion with topical estrogen therapy.Clin Pediatr (Phila). 2005; 44: 245
Article info
Publication history
Published online: October 29, 2018
Footnotes
Julie L. Strickland, MD, MPH is a Nexplanon instructor and receives an honorarium from Merck. The remaining authors indicate no conflicts of interest.
The findings of this study were presented, in part, at the 31st Annual Clinical and Research Meeting of the North American Society for Pediatric and Adolescent Gynecology, Chicago, Illinois, April 20, 2017.
Identification
Copyright
© 2018 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc.
