The topic of today's article will be the adhesion or fusion of the labia minora in girls. What is this condition? Is it considered a pathology or not? How to prevent synechia and how to treat this condition?
First, I want to acquaint you a little with the anatomy of the girl's external genitalia.
Anatomy of the female external genital organs
The vulva (external genitals) is a natural external "lock" of the vagina, formed due to the close (normal) contact of the inner surface of the labia majora and labia majora.
The tight closure of the genital slit directly depends on the integrity of the perineum and helps to protect the vagina from pollution from the external environment. In addition, it prevents the penetration of air into the vagina and rapid evaporation of vaginal secretions with drying (thickening) of the epithelium of the vaginal mucosa.
The labia minora are two longitudinal skin folds that have a good blood supply and innervation system and contain a large number of glands.
The labia minora (normally) in the lower third fit snugly together. This explains the most frequent adhesion of the labia minora in this particular part. Fusion or adhesion of the labia minora can be complete or incomplete and can occur anywhere.
It should be noted that this condition is very common among girls. It is observed at the age from birth to 6 - 7 years. In newborn girls (up to 6 months), due to the presence of residues of the hormone estrogen, which remained from the mother, fusion is rare. However, with each month of life, estrogen stores decrease, and there is a risk of sticking of the labia minora.
If you visit the forum of young mothers on the Internet or just talk with mothers on a walk, you can make sure that this condition occurs on average in every 5th girl.
There are many opinions among parents and doctors that the sticking of the labia is due to poor hygiene. Let's figure it out!
Causes of pathology
What are the reasons for the fusion of the labia minora? There are several of them:
- fusion or adhesion of the labia minora occurs most often due to excessive washing of the girl with frequent use of a fragrant soap. The well-known pediatrician E.O. Komarovsky also speaks about this. He believes that it is enough to wash the girl with soap once a day (at night). Using soap, mom washes away the entire flora of the vagina, thereby reducing its protection;
- using wet sanitary napkins is also a disservice;
- the use of diapers, their untimely change, when conditions are created not only for sticking the labia, but also for the reproduction of pathogens;
- wearing tight synthetic underwear;
- the result of the inflammatory process of the genitals (vulvovaginitis), urinary system;
- frequent bathing in dirty water leads to constant irritation, against the background of which the labia grow together quite often;
- allergic reactions when the skin comes into contact with the remnants of the powder on clothes;
- the labia are sticking together against the background of taking medications, food allergens.
Manifestations with fusion of the labia
Usually, if there is no urinary tract infection, there are no manifestations other than visual manifestations with the fusion of the labia.
At the next examination, the mother of the child or the doctor may see a thin, whitish film between the labia minora.
In the event that there is an attachment of an infection of the urinary system, when, due to the adhesion of the labia, the outflow of urine is disturbed (complete or almost complete fusion), discomfort appears during urination, the child begins to push hard, cry because of the pain syndrome.
In some advanced cases, a rise in body temperature is possible.
With constant contact of urine on the skin of the lower abdomen, linen, dermatitis may develop. If the nature of the fusion is allergic, then a rash may appear.
Diagnosis of synechia in girls
Sticking of the labia is more often diagnosed by the girl's mother. Indeed, the adhesion of the labia in girls is found during examination, as well as during a special examination - vulvoscopy.
In addition, a smear is taken without fail for microscopic examination, bacteriological culture for microflora.
If necessary (if an infectious nature is suspected), tests are prescribed: PCR, ELISA. If the nature of the adhesion of the labia is allergic, then an allergist-immunologist should be consulted.
How to treat and is it worth treating the fusion of the labia minora?
The opinion of pediatric gynecologists on this issue differs. Some prefers to fix the problem conservatively or promptly, and some insist that synechia should not be touched until the age of 10 years. This is explained by the fact that, approaching this age, the body begins to synthesize its own hormone estrogen, and synechiae are able to self-destruct.
However, mom wants to see her child healthy without this "thing". And mummies start ringing all the bells.
The condition in itself is not dangerous to life, but the likelihood of developing infections of the urinary system increases when the labia are sticking together, so it is also not worth inactive at all.
Therapy for the adhesion of the labia in a girl can be conservative, using ointments, creams, which include female genital hubbub, and surgical (destruction of synechia) in cases where traditional treatment has failed.
Conservative treatment includes the appointment of drugs such as Contractubex or estrogen-containing ointments and creams (Ovestin is a drug containing the female hormone estriol). Provides regeneration of the vaginal mucosa, restoration of the vaginal microflora, maintenance of the pH of the vagina at the proper level.
The release form of the drug is varied, but in pediatric gynecological practice it is used in the form of creams. It is freely dispensed without a doctor's prescription in Russia (it is not on sale in Belarus, it can be replaced with similar drugs that are sold only by prescription). Apply 2 times a day to the adhesion site for 14 days.
The average price of the drug is 1,500 rubles per tube. Due to their use, synechiae swell and collapse, relapses are possible. Estriol blocks only local receptors, absorption is minimal, therefore side effects in the form of enlargement of the mammary glands, the appearance of hairs, and pigmentation of the vulva are rare; when treatment is stopped, these manifestations disappear.
In the absence of the effect of conservative treatment and in advanced cases, when inflammation of the urinary system joins and the outflow of urine is disturbed, the synechiae is surgically removed. This procedure is carried out under local anesthesia and does not take much time, it is performed using a Volkmann spoon.
It should be noted that in 20% of cases, this condition recurs, therefore, after surgical correction, estrogen-containing creams and ointments are prescribed. In addition, surgical treatment can leave psychological trauma to the child. Therefore, you should not immediately run to dissect the synechiae, so as not to cripple the child's psyche.
Traditional medicine methods
There is a treatment for sticking labia with folk methods, namely, the use of calendula oil.
Due to its many beneficial properties, calendula is widely used in medicine. Calendula oil is obtained in a complex way, it has anti-inflammatory, wound healing, sedative, tonic effect. It is recommended to gently apply oil on synechiae in the labia minora in the morning and evening, after washing the child.
Another way of action when the labia is sticking is to wash the girl with chamomile infusion, which has anti-inflammatory, healing, antiseptic and many other useful properties.
But you should not engage in this type of treatment without the consent of a pediatrician.
Is it possible to prevent the fusion of the labia in a girl?
Can! Here's how to do it:
- use soap once a day to wash the anal area (after the act of defecation or before bedtime). It is recommended to use soap for washing the genitals no more than 1 time per week;
- wash the girl correctly (front to back) with warm running water;
- change diapers, diapers on time;
- to conduct air baths;
- limit the use of scented soaps, wet wipes, diapers;
- exclude allergenic foods;
- exclude tight synthetic underwear, replacing it with cotton underwear;
- in order to prevent the adhesion of the labia, you can periodically spread your child's labia with your hands, but without much enthusiasm and use of force.
