Document Detail

Estrogen treatment success in recurrent and persistent labial agglutination.
MedLine Citation:
PMID:  17174826     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: To estimate the success rate of conservative medical management and indications for surgery in cases of recurrent and/or persistent labial agglutination. DESIGN: A retrospective chart review was performed of girls treated for labial agglutination between 1996 and 2004. Records were reviewed for age, length of time of symptoms, previous treatments, results of topical estrogen therapy, and indications for surgery. SETTING: The study was performed in a tertiary care teaching university hospital. PARTICIPANTS: Charts of 67 girls with labial agglutination who were treated at the pediatric and adolescent gynecology clinic between 1996 and 2004 were reviewed. The average age was 4.1 years (range 0.6-14 years). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Improvement of persistent or recurrent agglutination labial agglutination with estrogen. RESULTS: Out of the 67 charts reviewed, 48 had recurrent or persistent disease. Within those 48 girls, initial treatments included: topical estrogen in 40 (83%), oral and topical estrogen in 1 (2%), topical estrogen in addition to manual separation in 5 (10%), and treated with manual separation alone in 2 (4%). Five girls were immediately treated surgically due to urinary problems or parents declining further topical treatment. Forty-three were treated with topical estrogen therapy with the following results: 15 opened either partially or completely, 9 required surgery, and 19 did not follow up. In the subset of girls with prior manual separation, 2 had resolution of adhesions with estrogen, 3 required surgery, and 2 had no follow-up. CONCLUSION: This study suggests that re-treatment of persistent or recurrent labial agglutination with topical estrogen therapy following detailed application instruction leads to avoidance of surgical intervention in at least 35% of cases. Even in cases which previously required manual separation, an attempt at conservative medical management may be considered.
Layne M Kumetz; Elisabeth H Quint; Senait Fisseha; Yolanda R Smith
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric and adolescent gynecology     Volume:  19     ISSN:  1083-3188     ISO Abbreviation:  J Pediatr Adolesc Gynecol     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-18     Completed Date:  2007-03-06     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  9610774     Medline TA:  J Pediatr Adolesc Gynecol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  381-4     Citation Subset:  IM    
University of Michigan Medical Center, Department of Obstetrics and Gynecology, Ann Arbor, Michigan 49109, USA.
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MeSH Terms
Administration, Topical
Child, Preschool
Estrogens / therapeutic use*
Retrospective Studies
Tissue Adhesions / drug therapy
Vulvar Diseases / drug therapy*
Reg. No./Substance:

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