Puberte öncesi kızlarda labia minora yapışıklıklarının cerrahi tedaviyle beraber medikal tedavisi

Abstract

OBJECTIVE: Labial fusion is a pathological condition seen mostly in prepubertal girls, claimed to be caused by low blood levels of estrogen and following inflammation. It is generally asymptomatic, however the adherence of labia minora may cause retention of urine leading to bacterial colonization and eventually causing urinary symptoms. The first choice of treatment is suggested as estrogen ointment. We aimed to investigate the success of surgical treatment together medical treatment with or without medical estrogen ointment before. MATERIALS and METHODS: Retrospective evaluation of 22 symptomatic with labial fusion patients who were admitted directly to our clinic or who were consulted following medical therapy by other clinics was made by means of the chart reviews. Mean age was 31 months. Labial adhesions were separated sharply by the help of a curved homeostatic clamp under local anaesthesia direction of anteroposterior. Following release of adhesion, estrogen ointment was applied topically. RESULTS: Among 22 patients, 19 of them had no problem in the post-management period. However, for three patients, re-release of adhesions by the same method was necessary. For all patients, follow-up revealed uneventful results. CONCLUSION: The first option in management of labial fusion is generally topical application of estrogen ointment; however the period necessary for treatment is long lasting. Mechanical release of adhesions under local anesthesia followed by topical estrogen ointment seems to lower recurrence rate and shorten the time necessary for treatment. Therefore, we suggest this treatment protocol since the treatment option for labial fusion may decrease the complication rate and build patient cooperation more easily.