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- In some infant girls or young girls,
one notices that the 2 ridges covering the vagina are stuck together. These ridges are called the labia minora. Since this blocks, or partially blocks, the opening to the vagina, it is necessary to separate the right labium from the left labium. Then the vagina will have a cleared opening.
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- Examining the region of the vaginal opening and urinary opening, one sees that the overlying labia minora look fused
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- This may be present at birth, or may occur later, as a result of irritation around the vagina.
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- Diagnosis is by inspection.
- If the labia block the free flow of urine, painful urination can occur.
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- Any condition that irritates vaginal tissue, such as infection
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- If this is detected in the newborn
period, or first few months of life, gentle separation of the slightly adherent tissue can sometimes be done in daily treatments, under a physician's guidance, during several weeks, by applying diaper cream and then gently easing the two labia apart.
- If this is not easily done, or the girl is older, estrogen cream may be needed. In older girls, the labia minora may not be easy to separate, and the tissue is now thicker. This may require daily application of a tiny amount of estrogen cream, under a physician's quidance, to the exact point where the two labia are fused. This will generally ease the two labia apart. One must take care not to apply too much estrogen cream, since it is a sex hormone and might enlarge the breasts if used in excess.
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- Obstruction to the outflow of urine
- In very rare cases, the bladder can become distended, causing a mass (the bladder) felt in the lower abdomen or pelvis.
- Obstruction to the outflow of vaginal secretions
- In very rare cases, the uterus can become distended, causing a mass (the uterus) felt in the lower abdomen or pelvis.
- Recurrence of labial adhesions after treatment is common, and separating the adhesions may need to be done several times.
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- Discuss with a physician if the 2 areas of tissue that cover the vaginal opening, look fused or are not easily pulled-apart.
- The younger the child when treatment is started, the easier it is to treat.
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- If the labia minora are actually joined as one continuous structure (instead of being slightly adherent), this can be a sign of a congenital defect (birth defect).
- Imperforate hymen might look similar to labial adhesion. However, the hymen is a layer of connective tissue that is an integral part of the vaginal opening; whereas the labia minora are flaps of tissue that are entirely outside of the vaginal opening.
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