Paediatric Labial Adhesions: Evaluation of Response to Topical Oestrogen Therapy

Abstract

Objective: To evaluate the differences in the response of labial adhesions to local oestrogen treatment in relation to age differences in a paediatric population.
Methods: This prospective observational study was carried out over 36 months. Consecutive patients referred for significant labial adhesions were given treatment with daily local oestrogen cream (Premarin) following a simple protocol of at least 2 weeks. Those with recurrent adhesions on subsequent follow-up were given further courses of treatment with the same protocol. The differences in the mean duration of treatment per episode, the total number of treatment episodes, and the total duration of treatment were then compared against the age of the children.
Results: A total of 104 patients presenting between 9 months and 6 years 4 months of age were recruited. All showed significant improvement in their adhesions after treatment. There was a trend of decreasing number of treatment episodes but increasing duration of treatment per episode as age increased from 1 year or below to 6 years or over (ANOVA, p<0.001). The mean total duration of treatment was 6.2 weeks at 1 year old or younger, but dropped to 4 weeks at 6 years or older (ANOVA, p<0.001). There were no major complications in any of the girls and manual separation was not needed in any of the cases.
Conclusion: Labial adhesions in paediatric age-group run a very benign course. Younger patients apparently had more rapid response to treatment, but a higher incidence of recurrent adhesions.