labial fusion

Last reviewed 01/2018

• labial fusion/labial adhesions may be defined as the partial or complete adherence of the apposing vulval labia minora
  • most frequently seen in infants and very young children
  • believed to be most often an acquired clinical condition rather than a congenital anomaly
  • labial adhesions and fusion in children in the absence of any other pathology is well documented
    • many cases are discovered incidentally during routine examination
    • only extremely rarely been noted to be present at birth - most authors regard it as an acquired condition
    • "physiological" fusion is postulated to arise in infants and young children with endogenously low estrogen levels who may or may not have an associated inflammatory condition such as vulvovaginitis
    • Leung et al found that labial fusion was most frequently seen in infants and young children, with a peak incidence of 3.3% in children ages 13 to 23 months o labial fusion has been described as a result of childhood genital lichen sclerosis, primary genital herpes, and chronic inflammation such as recurrent vulvovaginitis and urinary tract infections
  • labial fusion may be seen as a result of female circumcision
  • labial fusion is rarely seen in the postpartum period
    • may be spontaneous approximation of minor lacerations of the labia - uncommonly may result in distorted anatomical healing, with resultant dyspareunia, among other distressing symptoms
  • treatment methods described to divide labial adhesions vary considerably and include oestrogen cream, blunt or sharp surgical dissection under general anaesthesia, oral estrogen, bland emollients, and observation alone

Reference:

1. Arkin AE, Chern-Hughes B.Case report: labial fusion postpartum and clinical management of labial lacerations. J Midwifery Womens Health. 2002 Jul-Aug;47(4):290-2.
2. Powell J, Wojnarowska F. Childhood vulvar lichen sclerosis: an increasingly common problem. J Am Acad Dermatol 2001;44: 803–806.
3. Leung AKC et al. The incidence of labial fusion in children. J Paediatr Child Health 1993;29:235 236.