Approach to labial fusion in children: 16 years of experience

Abstract

Aim: We aimed to retrospectively evaluate the patients with labial fusion who presented to or were referred to the pediatric surgery clinic in a tertiary pediatric hospital.
 Material and Method: Between 01/01/2005 and 31/12/2020, 889 patients admitted or consulted to the pediatric surgery clinic due to labial fusion, age at the time of diagnosis, complaints on admission, which clinic referred the patient to the pediatric surgery clinic, treatments, recurrence, and complications were evaluated retrospectively.
 Results: The mean age of the patients was 2.21 (0.1–11) years. Most of the patients (82.5%) were asymptomatic. Parents noticed the condition and brought their child directly to the pediatric surgery clinic in 72.3% of the cases. Otherwise, patients were consulted to the pediatric surgery clinic from pediatric clinics, the pediatric endocrinology clinic, the pediatric nephrology clinic, or the pediatric emergency department. During the initial examination, manual separation was performed in 885 patients, and surgery was required for four patients. After the procedures, hydrotherapy with warm water and topical estrogen therapy were applied to all patients for 15 days. Recurrence was detected in 80 (9.0%) patients who were treated by manual separation. Manual separation was performed again in 78 of the patients, while surgical separation was performed in two (2.5%) patients who had severe fibrotic fusions.
 Conclusion: In the treatment of labial fusion, we recommend the combination of manual separation and topical estrogen cream treatment because it can be applied safely in the clinic, and the recurrence rate is low. Surgical separation is preferred in severe, thick, and fibrotic labial fusions.