Awareness about labia minora fusion among Lebanese pediatricians

Abstract

Abstract: The three main objectives of this study are to assess awareness about labia minora adhesion among Lebanese pediatricians, evaluate the number of those who perform a systematic gynecological examination in young girls and describe the management of this pediatric pathology in Lebanon in comparison with the literature review. Materials and methods: This is a cross-sectional descriptive study conducted in 2014 through a questionnaire that was answered by 117 pediatricians practicing in the different Lebanese regions. The data was analyzed on “Microsoft® Excel® 2013” in order to meet the three pre-described objectives. Results: 41% of the 117 pediatricians were familiar with the pathophysiology of labial adhesion. The lowest rates of awareness about this condition were reported in the South (7%) and Bekaa (13%). 80% of pediatricians routinely examine the female’s genitals. 26% of male pediatricians do not systematically examine female genitalia compared to 7.5% of female pediatricians (p = 0.02). 73% of the cases were discovered on a routine, systematic physical examination. The adhesion of the labia minora is associated in 23% of the cases with a urinary infection and in 16.65% with genitourinary symptoms. 9% of pediatricians made the diagnosis following the discovery by the mother. 83% of the doctors handled the case without a pediatric gynecology consult and then 42% referred the patient at a later time (to a pediatric surgeon in 82% of the cases). 17% initially adopt a conservative attitude; 75% apply creams with a recurrence rate of 16%. The highest rate of recurrence was observed in the case of manual separation (21%). Conclusion: The adhesion of labia minora is a common, benign, commonly asymptomatic, poorly recognized and underestimated condition in Lebanon. 1/5 of pediatricians, mainly males, do not examine the genital area of girls. 75% of the pediatricians resort to estrogenic creams or corticosteroids, and 17% are conservative.