VULVAR SYNECHIA


INTRODUCTION

Vulvar synechia is the union of the vulvar labia minora by their free edge, forming an avascular membrane between them. Non-birth synechiae develop with growth. If something similar was observed at birth you should rule out ambiguous sex. The etiology of synechiae is unclear (there is talk of physiological hypoestrogenism and / or chronic irritation of the vulvar region). A prevalence of up to 40% is reported and its incidence peak occurs between 13 and 23 months of age.


CLINICAL MANIFESTATIONS

It will be more or less obvious and will give more or less clinical depending on the extent of the synechia. When they are more extensive they can cause local irritation, pain from certain movements, and, less frequently, vaginal or urinary tract infections, or urinary retention.


TREATMENT

Up to 80% of cases the synechia will resolve spontaneously without intervention. They should be treated when there are symptoms or when there is parental concern. There are several treatment options: Topical Vaseline, Topical Estrogens, Topical Corticosteroids. The treatment option will have to be chosen on a case-by-case basis.

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