Labial Adhesions

Introduction

• Description: Labial adhesions (synechia vulvae) are agglutination of the labial folds that result in fusion in the midline.

• Prevalence: 1%–2% of female children.

• Predominant Age: Peak is 2–6 years; may be found at any age up to puberty. May also occur in postmenopausal women with significant vulvar atrophy or lichen sclerosus. May also occur as a complication of cosmetic vaginal or vulvar procedures.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Local inflammation and the hypoestrogenic environment of preadolescence.

• Risk Factors: Labial infections or irritation.

Signs and Symptoms

• Fusion of the labia majora in the midline (extends from just below the clitoris to the posterior fourchette)

• May be asymptomatic

• Retention of urine in the vestibule or vagina resulting in dribbling, irritation, discharge, and odor

• Recurrent urinary or vaginal tract infections

Diagnostic Approach