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Spontaneous resolution of labial adhesions in pre‐pubertal girls
Author(s) -
Norris Jean E,
Elder Charlotte V,
Dunford Angela M,
Rampal Deepti,
Cheung Charleen,
Grover Sonia R
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13847
Subject(s) - medicine , natural history , population , retrospective cohort study , cohort , pediatrics , family history , physical examination , conservative management , gynecology , surgery , environmental health
Aims This study sought to observe the rate and timing of spontaneous resolution of labial adhesions that had been diagnosed in pre‐pubertal girls. The secondary aim was to evaluate the conservative approach to management of labial adhesions that has been advocated by the Gynaecology Department, by assessing the rates of concurrent uro‐gynaecological symptoms in this population, as well as parent satisfaction with their child's management. Methods A retrospective chart review was performed of all patients diagnosed with labial adhesions in the Department of Paediatric and Adolescent Gynaecology between 2000 and 2017. Patients and their parents (depending on the age of the patient at the time of this study) were then invited to participate in follow‐up surveys and questionnaires and clinical examination. Results Of 148 girls identified, the median age of the follow‐up participants ( n = 45) was 6.1 years (2.6–27.2 years), compared with that of the entire cohort of 7.4 years (1–27 years). After a median follow‐up period of 2.6 years (0.4–20.7 years), 40% (18/45) of girls reported and/or had findings that supported resolution of labial adhesions without treatment. Two parents (4%) sought treatment elsewhere after their appointment. A history of UTI was reported in 30% (14/45) of patients, and 16% (7/45) had a known history of vulvovaginitis. Conclusions Our findings support the natural history of spontaneous resolution of labial adhesions. Concurrent uro‐gynaecological conditions that developed were successfully treated according to standard treatments. A conservative approach to the management of labial adhesions is associated with very low rates of parental concern and intervention.