Vulvar Synechiae in Girls: Causes and Treatment
Have you ever heard of this term? Vulvar synechiae are acquired abnormalities of the external genitalia of girls involving the fusion of the labia minora at either end.
They tend to cause few or no symptoms, so the diagnosis usually occurs late. On the other hand, if parents are attentive or if there’s discomfort, early visits to the doctor allow for a timely resolution. This is important because, although complications are rare, they’re still possible.
What are vulvar synechiae?
This is a benign gynecological condition that affects young girls, especially between the first and second years of life. In vulvar synechiae, the labia minora–which are part of the external genitalia and there’s one on each side–are attached and fused at one end.
For this reason, the line of fusion can include both the upper and lower ends. It usually tends to lateralize a little to one side or the other.
Find out more: The Female Reproductive System: How It Works
Symptoms of vulvar synechiae in girls
In the vast majority of cases, vulvar synechiae don’t cause symptoms. Of course, this depends on the extent of the lesion and the age of the girl. If the problem persists once she’s able to speak and express her feelings, she may communicate certain symptoms. For example, discomfort with urination, itching, and some pain when sitting or riding a bicycle.
Often, the diagnosis takes place when a complication occurs which makes a medical consultation more necessary. For example, having this condition increases the likelihood of lower urinary tract infections. These involve severe pain or burning during urination, fever, and changes in the pattern of urination.
If the fusion of the labia minora extends and becomes almost complete, one of the complications that may appear is the obstruction to the flow of urine, with the consequent retention that this causes. Pain in the lower abdomen (where the urinary bladder is located) is frequent, requiring urgent medical evaluation.
The most common causes
If a girl has vulvar synechiae, it’s always because she’s acquired them. This means that they appear at any time after birth and, in general, it’s not common for them to appear in the first weeks of life. For this reason, if a doctor observes lesions similar to this condition during a routine medical evaluation, it’s likely that there’s a different congenital abnormality.
Now, what are the causes of this disease? Any local injury or trauma capable of producing inflammatory reactions can cause adhesion of the labia minora. For example, when there are persistent diarrheal episodes or vulvovaginitis, vulvar synechia can occur.
What is the best treatment?
It’s important to remember that this is a benign condition that. Although it usually causes few symptoms, it requires treatment to prevent future complications. This depends very much on the extent of the lesion and the clinical picture. According to a publication of the Pontificia Universidad Católica de Chile, the most commonly used measures are the following:
- Non-pharmacological treatment includes basic hygiene measures to prevent the worsening of the initial situation. Daily washing with water and timely replacement of diapers are the easiest measures that can be implemented in almost any home.
- At the doctor’s office, it’s possible to use a swab with petroleum jelly to apply pressure along the scar to gradually release the vulvar synechia.
- On the other hand, pharmacological measures include the topical application of steroids. These drugs have anti-inflammatory properties, so they could facilitate the elimination of the adhesion after one or two weeks. Because of its adverse effects, it’s an alternative therapy that can’t be prolonged for too long.
A common and easily solved condition
Vulvar synechiae aren’t usually a problem, but because of the risk of developing discomfort and complications in the future, it’s advisable to see a doctor once the lesion is detected.
It’s good for parents to be familiar with the normal anatomy of the area, as well as to perform periodic evaluations during baths. This will allow the detection of abnormalities and early referral to the pediatrician.
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- BACON, J. 2002. Prepubertal labial adhesions: Evaluation of a referral population. Am J Obstet Gynecol. 187(2):327-332.