Thursday, October 27, 2011

Labial adhesions...ever heard of it?

I know sounds odd... but until my daughter was diagnosed with it at her 1 year appointment I never knew it existed. I'm sure she is really going to appreciate the fact that I blogged about this when she gets older but I feel that there may be a good educational opportunity here.
Labial adhesions effects approximately 4% of little girls and is relatively benign (harmless). In fact, if the pediatrician hadn't spotted it I would have never even noticed. Basically, adhesions of the labia is where the labia minora begins to grow together; in a sense closing up the opening to the vagina and urethra. Medicine is not really sure why this happens but it may be due to low estrogen (once levels from the mother drop) and/or to a moist environment created by diapers. If left alone it usually corrects itself once the child is potty trained or once she reaches maturation and estrogen levels normalize. This is all great news unless the opening to the vagina and urethra are completely obstructed thus trapping urine. This could lead to further infection and increased rate of urinary tract infections.

As a mother, I hated the idea that my daughter may have some sort of "problems" with either elimination or sexual intimacy in the future. As a mother, you generally excessively worry anyhow :) So, how is it treated? There are different schools of we soon learned. Our first pediatrician (since changed because of this) advised us to slowly massage the tissue open every evening. In fact, she tore it open slightly during the office visit without even consulting us first. As you can imagine, this led to miserable diaper changes as I'm sure it was painful. As a mother and a nurse I felt immensely wrong about the entire process. I was sure that there was an alternative, after all, the tissue was going to have to heal and I knew that it was likely to heal back upon itself. After discussing with doctors (neonatologists) at work and doing some of my own research I eventually decided to find a new pediatrician and get a second opinion. I stopped massaging the area and monitored it as we noticed that the hole was getting smaller and smaller. When we finally saw the new doctor the hole was just big enough to squeeze urine through. This time around we were given much more reassuring news. Our doctor prescribed an estrogen cream to be applied daily and it would slowly open up again with minimal pain and/or side effects. Whew... that was a relief!
I'm here to say that at our 15 month check up today, Paige is free from adhesions and diaper changes are much more bearable. She is prone to get them again, but for now the cream is discontinued and we will have to keep a close eye on it. I'm just happy that she should no longer experience any pain associated with that region of her body and that she shouldn't have any residual effects into adulthood.
Moral of the story... always trust your intuition.
For further information regarding labial ahdesions check out....

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