Labial adhesions may be seen in young girls and may be partial or complete (fusion) and asymptomatic. However, labial adhesions can be associated with difficult or abnormal urination and may contribute to the development of UTIs. It is important to perform an external genital examination in the female with her first UTI (Fig. 40-10). Retrospective data and case series support topical estrogen cream to the affected areas, with gentle traction until the adhesions have separated (Bacon, 2002). In a recent study, however, labial separation occurred more quickly and with less recurrence in patients treated with betamethasone than in those treated with estrogen cream (Mayoglou et al., 2009).
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