In the case of labia synechia, the labia minora stick together and can provide a breeding ground for bacteria over time, so that urinary tract infections and even hydonephrosis are favored. The most common cause of the phenomenon is trauma to the epithelial layer. The treatment is carried out by daily application of an ointment with the active ingredient estrogen.
What is labia synechia?
About a third of all patients often suffer from urinary tract infections due to adhesion of the labia minora. Bacteria collect in the adhesion area of the labia minora and migrate into the urinary tract, where they cause inflammation. See AbbreviationFinder for abbreviations related to Labia Synechia.
The labia minora are the small labia. Medicine also knows synechia as an adhesion. If the labia minora adhere to each other completely or partially, this is called a labia synechia. The prevalence of the disease is given as two to five percent. Girls between the ages of three months and four years are particularly affected.
The labia synechia reaches its peak between the 13th and 23rd month of life. In individual cases, the labia synechia can also exist immediately after birth. In the case of a synechia of the labia minora, however, there are no direct adhesions. This connection distinguishes labia synechia from any malformations that can be traced back to a genetic cause, external factors during pregnancy and disorders in embryonic development.
Causes
Labial synechia can have various causes. For example, trauma leads to abrasion of the superficial epithelial layer. This can lead to scarring, which leads to adhesion of the two labia. Inflammations such as vulvitis or vulvovaginitis are possible types of trauma in this context.
The cause of such inflammations can be poor hygiene. Seborrhea or atopic dermatitis can also cause inflammatory reactions. The same goes for pinworms, a laceration of the labia minora, or a split. In addition, sexual abuse and masturbation are possible causes of the trauma.
In individual cases, estrogen deficiency is the primary cause of labia synechia. With such a deficiency, the strength of the epithelial cells can decrease. Trauma to the labia is at least favored by this.
Symptoms, Ailments & Signs
The labia synechia manifests itself clinically in different symptoms. Abnormal voiding is the main symptom. In addition to a deviating stream of urine during the actual act of micturition, a strong dribbling after micturition can occur. In some cases, an additional obstruction was found, which may be associated with bladder dilatation or hydronephrosis.
About a third of all patients often suffer from urinary tract infections due to adhesion of the labia minora. Bacteria collect in the adhesion area of the labia minora and migrate into the urinary tract, where they cause inflammation. Around 20 to 40 percent of patients are affected by this symptom. Alternatively, the manifestation may correspond to asymptomatic bacteriuria.
In this case bacteria collect, but they are excreted with the urination and do not cause urinary tract infections or other secondary diseases. Since vulvitis is considered a possible cause of labia synechia, such an inflammation can complete the clinical picture in individual cases.
Diagnosis & course of disease
The diagnosis of labia synechia is made on the basis of the clinical picture. Because most girls with labia minora adhesions remain relatively asymptomatic, physicians often diagnose synechia as an incidental finding during a routine examination. Urogenital shows a flat vulva and adherent labia from the midline to over the clitoris.
The membrane of the labia shows through thinly over the introitus and the hymen. The prognosis for affected patients is good. The symptoms mentioned above, such as the deviating urine stream, nighttime dribbling, bacteriuria and urinary tract infections usually only appear later in the course. After early detection and subsequent treatment, most patients remain completely asymptomatic. Further clarification is usually not indicated in the case of adhesions of the labia minora.
Complications
As a rule, infections of the urinary tract occur due to the labia synechia. These infections can be very unpleasant and can also lead to pain when urinating, for example. Patients are often ashamed of this complaint and suffer from burning pain. The constant pain can also lead to depression or other psychological upsets and complaints.
Furthermore, the patient’s sexual intercourse is significantly restricted due to the labia synechia, which can lead to tension in a relationship. The quality of life of those affected is significantly restricted and reduced by this disease. In most cases, the treatment of this disease is carried out with the help of drugs, creams and ointments. The treatment is usually successful and there are no particular complications or other symptoms.
As a rule, the course of the disease is positive. Only in rare and serious cases are those affected dependent on surgical intervention. The patient’s life expectancy is not reduced or curtailed. There are no other complications either.
When should you go to the doctor?
Women who have trouble urinating should speak to their gynecologist . Medical advice is also required if urinary tract infections occur again and again or other unusual symptoms in the genital area are noticed. Symptoms that persist for a long time or recur after a symptom-free phase indicate a serious condition such as labia synechia and must therefore be examined. Burning pain when urinating and problems with sexual intercourse are indications that the disease is already advanced.
In order not to risk any further complications, the affected women should speak to their gynecologist immediately. Parents who notice signs of labia synechia in their child should not hesitate to consult a doctor. Inflammation in the genital area and hormonal problems are possible triggers for adhesions in the labia. A worm infestation and eczema in the area of the vagina are also conceivable causes that need to be clarified. If the symptoms occur in connection with the diseases mentioned, it is best to consult a specialist directly. In addition to the gynecologist, an internist or a dermatologist can be consulted.
Treatment & Therapy
A labia synechia is never resolved manually. The risk of traumatic injury to the epithelial layers is high when the adhesion is broken manually. Scars often remain and repeated adhesion can be promoted. A surgical separation of the labia is just as little indicated as the manual solution.
Treatment is conservative and, in asymptomatic cases, is limited to therapy with conjugated cream containing the active ingredient estrogen. Premarin is used particularly frequently. The patient or the patient’s parents are instructed to apply small amounts of the cream to the site of the adhesion each day. Depending on the strength of the adhesion, it may also be necessary to apply the cream twice a day.
As a rule, this treatment resolves the synechia of the labia minora within a month at the latest. The cream treatment has a success rate of around 90 percent. If a urinary tract infection is already present, the patient will also be prescribed antibiotics to combat bacterial colonization. The same applies to the presence of a vulvitis. Surgical intervention is only indicated for obstruction with hydronephrosis. The procedure removes the obstruction and ideally resolves the hydronephrosis at the same time.
Outlook & Forecast
The prognosis for labia synechia is usually very favorable. The life expectancy is not limited by the disease and there are no late effects. Affected girls under the age of six in particular often heal quickly without further complications.
In many cases, the adhesions of the labia resolve themselves within a few weeks or months. In some patients it is completely asymptomatic during this time. Labia synechia does not always have to be treated medically. Treatment usually leads to quick success. Therapy with estrogen-containing creams causes a rapid improvement in symptoms. Within a few weeks, the labia synechia dissolves completely.
Especially if the therapy is stopped prematurely, it can happen that the labia stick together again. Repeating the treatment usually leads to complete healing. If the disease is not treated for a long time despite severe symptoms, complications can occur. As a result, surgical treatment is rarely necessary, which is usually carried out on an outpatient basis. The prognosis is generally very good. However, scarring of the affected tissue can occur, which usually heals within a few months.
Prevention
In order to prevent labia synechia, a prophylactic treatment step is available. This prophylaxis is used primarily when a recurrence is to be prevented after adhesion of the labia minora and their dissolution. The most common prophylaxis is the application of Vasiline, which takes place once a day in the area of the previous adhesion. If there has never been an adhesion in the past, any preventive measures are usually not necessary.
Aftercare
In the case of labia synechia, the patient usually only has a few or even no special options for aftercare. First and foremost, the disease should be diagnosed and treated quickly so that no further complications and symptoms can occur. As a rule, self-healing cannot occur, so that treatment by a doctor must always take place.
In most cases, the disease is treated by applying a cream. Those affected should pay attention to the correct application and also to the correct dosage of these drugs. In many cases, the parents also have to check that the children are using it correctly so that the symptoms are alleviated properly and, above all, permanently.
Since labia synechia is often associated with a strong feeling of shame and reduced self-confidence, loving and intensive conversations with the child are very helpful and important. Contact with other people affected can also be useful, as this leads to an exchange of information. These can then make everyday life easier for the patient. As a rule, labia synechia does not reduce the patient’s life expectancy.
You can do that yourself
As a rule, no special options for self-help are possible or necessary in the case of labia synechia. The treatment of the disease is carried out with the help of creams and ointments, surgical interventions are not necessary. The cream should be applied no more than twice a day to avoid irritating the skin.
Since labia synechia can also lead to an infection of the urinary tract, the patient should see her gynecologist or a urologist to avoid further problems. These infections are usually treated with antibiotics. The person concerned should avoid alcohol and treat any possible interactions with other medications. In order not to delay the treatment of labia synechia, the affected person should also refrain from sexual activities during this time.
In the case of psychological complaints, depression or inferiority complexes, talking to close friends or your partner is a good idea. Above all, the reduced self-esteem can very often be increased. The exchange of information with other affected persons may also contribute to a positive course of the disease. However , psychological treatment is necessary if the labia synechia has occurred as a result of sexual abuse.
