What is Labial Fusion?
Labial fusion is a condition where the labia minora (the inner labia) fuse together, obscuring the hymen and vagina. It can sometimes be confused with vaginal agenesis, a much rarer condition in which the vagina does not form.
Why Does Labial Fusion Occur?
Labial fusion in children occurs due to irritation of the edges of the labia minora, most commonly in response to nappy rash. As the labia are pressed together they subsequently fuse due to this irritation.
How will I know my daughter has labial fusion?
Most of the time labial fusion is asymptomatic. In some children it can lead to irritation of the area, due to retained urine behind the fusion. While there is often a small gap at the top for urine to escape, some may remain. This can lead to an odour or discharge from the vulva. It may manifest as apparent recurrent urinary tract infections. It can also lead to itchiness – so they might scratch down there, or against furniture in an attempt to ease the irritation. You may notice a change in the appearance of the vulva during nappy changes – this is the most common first sign parents report.
Is Labial Fusion Dangerous?
Labial fusion is not dangerous, but can be socially inconvenient if any of the above behaviours or signs are noted by parents or caregivers. In some children, fusion can lead to recurrent urinary tract infections, though this is rare.
Labial fusion often resolves spontaneously, and it does not have any consequences as an adult.
How is Labial Fusion treated?
In many cases, no treatment at all is required other than explanation and reassurance, as labial fusion often resolves spontaneously and asymptomatically. Treatment is reserved for cases with symptoms, or if parents prefer not to wait.
The traditional treatment for labial fusion was to apply oestrogen ointment to the fused labia in the midline. This is effective, but can lead to unwanted side effects similar to puberty. Steroid ointments (betamethasone) are equally effective with none of the side effects, and are now used instead.
Parents apply the ointment twice daily. It softens the skin, and the pressure of application slowly separates the fusion. Application of the ointment then helps to prevent re-fusion. Steroid ointment can be substituted by white soft paraffin (Vaseline) once separation has occurred.
Does Labia Fusion Need Surgical Repair?
In most cases, labial fusion does not require surgery.
Surgery is reserved for symptomatic children whose fusion has not separated with topical ointment application. This is now usually done under a general anaesthetic. Parents will need to apply Vaseline to the area for some time post-operatively to prevent the fusion recurring.
When to Seek Medical Attention for Labial Fusion
While most labial fusions resolve naturally, it’s important to monitor your child for signs that may require medical attention. Seek emergency care if:
- Your child develops urinary tract infections.
- Your child has a malodorous discharge.
- Your child is scratching or rubbing themselves, or up against other objects.
- Your child has bleeding.
- Your child experiences vomiting or refuses to feed.
Monitoring and Care for Labial Fusion in Children
Labial fusion is a common condition in prepubertal children and generally resolve without intervention. In the vast majority of cases, no surgery is required. Parents should keep an eye out for the signs and symptoms mentioned above. If you notice any worrying symptoms, consult your doctor for further advice.
Related Information
For more information about the surgical treatments for anorectal malformation, visit our Surgery for Anorectal Malformation page.
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