Labial Adhesions Mostly Treated Non-Surgically

Research Article| September 01 2025 Labial Adhesions Mostly Treated Non-Surgically Available to Purchase AAP Grand Rounds (2025) 54 (3): 33. https://doi.org/10.1542/gr.54-3-33 Views Icon Views Open Menu Article contents Figures 54 (3): 33. https://doi.org/10.1542/gr.54-3-33 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search toolbar search search input Search input auto suggest filter your search All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: labial adhesions Source: O'Keefe RJ, Compton SD, Dendrinos ML, et al. Management variation in pediatric labial adhesions: a retrospective cohort study. J Pediatr. 2025 Jun:281:114529; doi: https://doi.org/10.1016/j.jpeds.2025.114529.Google Scholar Investigators from the University of Michigan, Ann Arbor, MI, conducted a retrospective study to describe variations in the management of girls with labial adhesions (LA) and assess outcomes in patients treated with surgical adhesiolysis. Participants were patients ≤21 years old seen at a single institution who were diagnosed with LA between July 2022 and June 2023. The medical records of study patients were reviewed and demographic and clinic data abstracted. The type of clinician, eg, primary care provider (PCP), making the diagnosis of LA was noted, and providers treating girls with LA were classified as PCP, pediatric and adolescent gynecologist (PAG), pediatric urologist (PUR), and other. Types of treatments were categorized as observation, topical, manual traction in the clinic, and surgical. Surgical adhesiolysis was classified as either blunt (ie, with a coated cotton swab) or sharp blade (scissors). The rate of use of each type of treatment was calculated. For patients treated with surgery, the recurrence rate was also determined. Data were analyzed on 159 girls with LA. The age of study patients ranged from 0 months to 8 years at diagnosis, with a median of 12 months. The initial diagnosis of LA was made by a PCP in 140 (88.1%) cases, primarily by a pediatrician (N = 134; 84.3%). Among the participants, 81 (50.9%) were managed by the diagnosing PCP, and 78 (49.1%) were referred to a subspecialist (41 59.0% to a PUR, 32 41.0% to a PAG, and 5 6.4% other). There were 41 girls who presented with urinary symptoms, including 28 (17.6%) with a history of urinary tract infection and 13 (8.2%) with dysuria, postvoid dribbling, or urinary retention. Initial therapy included topical treatment in 132 (83.0%) girls, observation in 25 (15.7%), and manual traction in 2 (1.3%). Overall, topical estrogen was prescribed to 111 (69.8%) patients, topical emollient to 101 (63.5%), and topical betamethasone in 9 (5.6%). Ultimately, 140 (88.1%) girls were managed without surgery. There were 19 (11.9%) patients treated surgically, 8 by PAGs, 10 by PURs, and 1 by an adult surgeon. The mean time from diagnosis of LA to surgery was 28 months for girls treated by PAGs and 18 months for those managed by PURs (P = 0.38). Blunt adhesiolysis was the surgical treatment in 11 patients, and sharp adhesiolysis in 6, with sharp adhesiolysis performed exclusively by PURs. LA recurred in 6 (31.6%) of girls treated surgically, at a median age of 5.0 years. The authors conclude that most girls with LA were managed without surgery. Dr Goyal has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device. LA are a common condition in prepubertal girls, thought to arise from a state of naturally low estrogen,... You do not currently have access to this content.