Labial adhesions occur when the inner lips (labia minora) of the vulva (outside of the vagina) stick together. This occurs most often in girls between 3 months and 6 years of age.
Parents may notice their child’s vaginal opening looks partially or completely blocked or see a white line when looking at the vulvar area. A child may experience pain when straddling objects, trouble passing urine or have frequent urinary tract infections. An older girl may dribble urine when it becomes trapped behind the adhesion after using the bathroom. There is no definite cause of labial adhesions other than low levels of estrogen, which is normal for girls in early childhood, particularly prior to puberty.
A pediatrician or healthcare provider may diagnose labial adhesion during a regular examination. An adhesion shows itself as a white line in the vulvar area. The vaginal and urethral (pee channel) opening may be partially or fully covered by the labia.
Your child’s pediatrician may monitor smaller, milder adhesions that do not cause symptoms. In most cases labial adhesions disappear within a year after diagnosis without any treatment. Due to a lack of estrogen, labial adhesions can occur more than once until a child reaches puberty.
Large adhesions may require application of a mild emollient or petroleum jelly and gentle manual pressure to separate the labia. Adhesions that block the vaginal or urinary openings may be treated with a prescription estrogen-based cream or steroid cream (bethamethasone) and may need a minor procedure to separate the labia.
A pediatrician can treat most labial adhesions, but some cases are referred to a pediatric urologist. Pediatric urologists may use an office procedure like manual separation or in rare instances a short outpatient surgery to separate the labia. Barrier cream such as Vaseline®, Aquaphor® or triple antibiotic ointment is used once or twice a day for 6 to 12 months after adhesions are opened to prevent recurrence.
In addition to treatment, it is important that potty-trained girls practice good toileting hygiene and practices: good voiding posture and spreading their legs when using the bathroom.
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