Labia minora in a newborn. Synechia in girls - solving a delicate problem. Diagnosis of fusion of the labia minora

Many parents have no idea what synechiae of the labia minora is. At lectures for expectant mothers, this problem is not mentioned. Therefore, mother, although she is a woman herself, cannot always determine the presence of the disease. So what is it? Synechia, simply put, is the sticking together of the labia. In this case, both the labia minora and the labia majora can grow together. Fusion can be complete or partial.

Synechia of the labia can be suspected by self-examination of the child.

Before examining your daughter, you must:

• Wash your hands thoroughly.
• Get rid of long nails, otherwise you can injure the baby.
• Turn the baby onto his back.
• Spread your legs as carefully as possible and proceed directly to examining the genitals.

After opening the labia majora, you can see that the labia minora are in close contact, and there is a membrane between them. The vagina is invisible, or only a small part is visible. Attempts to disconnect will be unsuccessful. The girl will feel pain and start crying.

If there are no deviations, the gap will be large and the vagina will be noticeable. The labia minora are petal-shaped and easily separated from the labia majora.

How to distinguish synechiae

The most important symptom is impaired urination. The child will feel difficulty and will have to push. It will become easier after you manage to pee. The situation becomes especially acute at night - it is difficult for the baby to fall asleep.

It’s worth examining the girl when you notice:

• Redness in the genital area, slight rash.
• The child complains of pain and discomfort in the vaginal area (cries, worries).
• It has become difficult to wash the baby - she shudders and cries.
• The stream of urine is raised upward, like a boy's.
• Urine leaks, the child goes to the potty, but the laundry becomes wet.

Synechia in infant girls

Already from the first weeks of life, fusion of the labia in girls can occur. It is generally accepted that the cause of this phenomenon is a low amount of sex hormones in the body. But there is nothing strange in this, because sex hormones may be absent until puberty occurs, and this is quite normal.

Until the eighth year of life, the disease can appear again. With age, the mucous membranes of the genital organs become more resistant to external irritants, gaining density. There is practically no sticking of the labia.

Causes

The disease can develop due to:

• Household allergic reactions to soaps, oils, wipes, powders, creams.
• Frequent washing is not enough.
• Using soap when washing.
• Improper washing that is harmful to health.
• Infections.
• Intestinal dysbiosis and weakening of local immunity.
• Presence of worms in the body.

To determine the causes of the development of synechiae, specialists prescribe tests. It will not do without vaginal smears, general blood and urine tests, stool tests to determine dysbacteriosis and worm eggs, and scrapings for enterobiasis.

Treatment

If detected early, the breeding procedure is much easier. At the initial stage of the pathology, the film will be thin and transparent, but if complete fusion of the labia minora occurs, it becomes dense, and without surgery it will no longer be possible to eliminate the problem. There is no need to do such procedures on your own, otherwise you can cause irreparable harm to children's health.

When there is the slightest suspicion of synechia, you should make an appointment with a pediatric gynecologist to receive qualified advice.

In addition, there is not always a need for breeding - this procedure is done only in cases of discomfort and pain for the girl.

How is the treatment carried out?

Only pediatric gynecologists perform dissection of synechiae in girls. For surgical interventions, a scalpel is used. The process takes a matter of seconds and takes place under local anesthesia. In the postoperative period, the baby will need special care.

To relieve pain when urinating, to promote rapid wound healing, you cannot do without sitz baths, lotions, and special ointments with an antibacterial effect. Antimicrobial agents are prescribed by the doctor after the operation is completed.

But you need to understand that performing an operation does not guarantee that the pathology will not appear again. Fusion of the labia minora may recur. Parents have the right not to resort to this technique, but they cannot do without it when a complete fusion has formed, during which it is very difficult for the child to go to the toilet. There are no other ways to help the baby.

Preventive measures

To prevent the formation of fused labia, experts advise:

• Observe personal hygiene rules.
• Do not use shared towels, etc. for child care.
• Apply baby cream and vegetable oil in small quantities to the labia area.
• Don't forget about regular air baths, they are very beneficial for children's skin.
• Treat any inflammatory diseases of the genital organs in a timely manner.

Washing should not only be regular, but also correct: running water, gentle movements of the fingers from front to back - to avoid infections. Mom's nails should not be too long. Do not wash with a washcloth, otherwise the risk of damage to the delicate tissues of children's genital organs increases. Soap should not be used. Few modern parents are ready to completely give up diapers, but not everyone knows about the rules of use: changing once every three hours or as the need arises.

Allowing your baby to be naked for a little while - air baths are very beneficial for the genitourinary system and skin. Select underwear from good fabric, according to size. Children's clothes should be washed separately from adult clothes. If a child is prone to developing allergic reactions, you need to carefully monitor the condition of the skin of the perineum, use diaper rash cream, and do not overdo it with potassium permanganate baths.

Treatment at home

Treatment at home is possible only for partial and uncomplicated fusions. In these cases, warm baths are used in a sitting position. Medicinal herbs must be added to the water in small quantities (we are talking about calendula, string, chamomile). One procedure should take no more than 10 minutes. Then apply sea buckthorn or peach oil to the site of pathology formation. Choose only natural products, there should be no impurities. Pre-check for allergic reactions to different types of oils.

Synechia cream

With the progression of the disease and severe discomfort, specialists prescribe creams containing hormones. Use a strictly limited amount only once a day. Apply using a clean index finger, exclusively to the affected area. The duration of use should not exceed two weeks. After completing the treatment course, the children's genital area is subject to treatment with baby creams without fragrances (after washing is completed).

It is worth monitoring the condition of the genital organs by doing regular examinations - this is the only way to prevent synechiae in girls.

Many mothers are very worried about frequent relapses of this pathology. This indicates that something has gone wrong in the body. In case of frequent relapses, it is necessary to contact a gynecologist and undergo a full examination by a specialist.

Last article updated: 04/09/2018

This article will focus on one of the most common problems in both adult women and girls, as well as boys: synechiae. How to treat synechiae in girls and is there a way to prevent synechiae? Read on for answers to these questions, as well as useful recommendations from experts.

Obstetrician-gynecologist, reproductive specialist

Synechia is an adhesion, fusion of tissues with each other, when connective tissue cords form between them.

In gynecology, synechiae are found: intrauterine, in the fallopian tubes, labia minora and labia majora in girls. Boys have synechiae of the penis.

The presence of intrauterine synechiae in women is called Asherman's syndrome. This pathology is often found in women of reproductive age and is a fairly important problem, as it often leads to infertility and miscarriage.

Causes

The reasons for the development of intrauterine, as well as synechiae in the cervical canal, are most often mechanical damage to the inner layer of the endometrium as a result of curettage.

This procedure is performed in the case of various pathological formations of the uterine cavity (polyps, hyperplasia, uterine fibroids, non-developing pregnancy). Curettage is also possible during surgery (cesarean section), or during metroplasty due to a malformation of the uterus.

In addition, intrauterine synechia develops as a result of inflammatory processes of the endometrium (endometritis). Its occurrence is facilitated by sexually transmitted infections, intrauterine devices, their long-term use, tuberculosis of the genital organs, and multiple abortions.

As mentioned above, intrauterine synechiae, or Asherman's syndrome, is represented by connective tissue cords that fill the uterine cavity throughout or partially. The clinical manifestations of this syndrome will depend on this.

If the synechiae in the uterine cavity are tender, thin, then often clinical manifestations may be absent, and if they are rough and fill the entire uterine cavity, then Asherman's syndrome will manifest itself as menstrual irregularities (painful periods, a decrease or complete absence of menstrual flow, as well as accumulation in the uterine cavity due to the inability to defecate, miscarriage, infertility).

Synechiae in the cervical canal and intrauterine are diagnosed by ultrasound on a certain day of the menstrual cycle and require additional medical intervention, namely hysteroscopy, during which they are dissected.

Severity

Highlight 5 degrees of severity of this adhesive process in the uterine cavity:

1. Delicate thin synechiae of the uterine cavity, which are easily destroyed by a medical instrument, free mouths of the fallopian tubes.
2. When a single dense adhesion is found in the uterine cavity, but it is easily destroyed by the hysteroscope tube, at this degree the mouths of the fallopian tubes also remain free.
3. When multiple dense synechiae and closure of one of the mouths of the fallopian tube are detected in the uterine cavity.
4. When a larger area of ​​the uterine cavity is filled with dense, rough synechiae and complete blockage of the orifices of the fallopian tubes.
5. Severe fibrosis, the presence of coarse dense adhesions in the uterine cavity, menstrual irregularities, namely a decrease or complete absence of menstruation. In addition, synechiae can be observed in the area of ​​the cervical canal, closing the entrance to it, which requires their dissection.

Asherman's syndrome often causes infertility that a woman experiences when planning a pregnancy. Therefore, it is necessary to timely predict and prevent this pathology of the uterine cavity.

Measures to prevent adhesions in the uterine cavity:

• timely treatment of inflammatory processes of the pelvic organs in any age group;
• competent contraception and its promotion among the younger generation in order to reduce the number of unwanted pregnancies;
• in case of choosing instrumental or medical termination of pregnancy, preference should be given to medical termination;
• carry out endometrial curettage procedures under mandatory ultrasound control;
• limit the use of intrauterine devices for contraception or change them in a timely manner.

Synechiae in children

But synechiae can occur not only in adult women, but also in girls.

Synechiae in infants and in childhood represent adhesion or fusion of the labia minora and/or major, fusion from posterior adhesions - posterior synechiae. In many cases they are called synechiae of the vulva. Translated from Latin, the word “synechia” means “continuity, connection.”

The adhesive process can be observed both along the entire length of the labia, and in a certain area (in the lower third), that is, partial adhesion is noted.

The main question that worries every parent is: what does the treatment of synechia include and whether it is worth separating the synechia.

A delicate, thin, transparent film is formed that partially blocks the entrance to the vagina (with incomplete adhesion) and completely covers the entrance to the vagina and urethra (with complete adhesion of the labia).

In this case, it is necessary to breed synechiae in girls.

They are most often observed in girls aged 6 months to 6 years (usually diagnosed before one year of age)

They arise both within a few days and within several months.

There are 5 main reasons why synechia develops in girls.

The reasons for the development of adhesions in the labia area in girls, as well as in adult women, are: are:

• inflammatory process (vulvitis, vulvovaginitis);
• a consequence of an allergic reaction (with abuse of sweets, citrus fruits);
• violation or, conversely, excessive hygiene of a girl with repeated use of soaps, when, as a result of frequent washing of the girl, injury to the mucous membrane occurs and, as a consequence, inflammation with the subsequent formation of synechiae;
• urinary tract infections;
• tight-fitting underwear made of synthetic fabrics.

Thus, knowing the main reasons for the development of adhesions, it is possible to prevent the development of synechiae in girls.

Such frequent fusion of the labia at such an early age can be explained by the low content of the hormone estrogen, the level of which begins to increase from 7 to 8 years of age.

Symptoms during the formation of fusions of the labia may be absent in the case of incomplete adhesion. In such a situation, a doctor can make a diagnosis during the next examination.

But if a commissure has formed along the entire length of the labia, thereby completely blocking the entrance to the vagina and urethra, then the following signs:

• the child begins to be capricious when urinating;
• straining when urinating;
• cries;
• a stream of urine hitting the lower abdomen;
• in rare cases, an increase in body temperature is observed.

Treatment of synechiae of the labia in children can be conservative (that is, without instrumental interventions) and surgical (using surgical instruments).

Currently, the formation of adhesions in the labia area in children is not considered a pathology (since low estrogen levels in girls up to a certain age are the norm). In this regard, it is believed that synechiae themselves are not a pathology.

Therefore, in case of incomplete fusion, in the absence of clinical manifestations, the synechiae are not separated in girls, but an ointment containing estrogen (Ovestin) and dynamic observation are prescribed.

Ovestin is a drug containing the female sex hormone estriol. It is widely used for synechiae. When the labia stick together, a small amount of ointment is prescribed to be applied to the area of ​​the fusion, that is, to the septum, with a gradual transition to regular ointment containing lanolin to prevent re-sticking.

The drug is sold freely in Russia, without a doctor’s prescription. Its price is about 1,500 rubles per tube. Reviews about the use of the drug for the treatment of synechia in girls are only positive.

If you read on the forum, you can note that many children, according to their mothers, do not have synechiae separated. For fusion of the labia, a gel is prescribed Contractubex(made in Germany). According to the instructions, Contractubex gel is used for gross deformation of the skin, cicatricial changes in the skin, and stretch marks in the postpartum period. I would like to note that nothing is said about breeding synechiae in girls using Contractubex gel. Therefore, you need to think very carefully whether it is worth using this drug in children!

Another frequently prescribed drug for the formation of synechiae of the small lips in a child is ointment Bepanten(contains dexpanthenol). According to the instructions, this ointment is used to accelerate the regeneration of the skin and mucous membranes due to the content of vitamin B5. However, the instructions say nothing about use for fusion of the labia minora in girls!

Solcoseryl- a drug that is also used for adhesions. Yes, the instructions for the drug say that it is used to improve tissue trophism and regeneration. But sticking of the labia is not an indication for the use of this remedy.

Treatment of synechia in a girl with folk remedies

In folk medicine, synechiae in girls is treated with castor oil, applying a small amount of it to the fusion area of ​​the labia minora. It should be noted that castor oil is used not only in gynecological practice. Due to its diverse beneficial properties, castor oil is also used in cosmetology.

Dear mothers, think carefully before using this or that drug that was recommended to you by a friend on the forum. It's best to see a doctor! Only a competent specialist can decide whether it is worth spreading the adhesions between the lips or whether this process can be cured without the use of intervention.

If the urinary tract is involved in the process and there is an acute urination disorder, the synechiae are destroyed surgically, followed by the administration of Ovestin in order to avoid relapses of adhesion. With surgical destruction of the fusion, relapses are observed in 30% of cases.

Synechia in young girls is a fairly common phenomenon, which is mostly asymptomatic. It is possible to understand that the baby’s labia minora or majora are stuck together only with a visual examination. After surgery, in 30% of cases, girls experience relapses and re-fusion of the vulva.

Often, synechiae is the cause of cystitis due to difficulty urinating and the development of an inflammatory process in the vagina due to the accumulation of vaginal discharge. The disease can lead to various serious consequences for the female body - problems with conceiving a child and childbirth. To avoid the development of complications, parents should take timely measures to treat fusion of the labia in children.

What are the causes of the pathology?

Synechiae often occur in girls aged 1 to 7 years. In infants under 1 year of age, pathology is practically not observed. With a decrease in the level of the estrogen hormone, which the baby inherited from the mother, the likelihood of sticking together of the labia minora and labia majora increases. In boys, this concept refers to the fusion of the foreskin with the head of the penis. Among the causes of a fused vulva are:

The listed factors are also the reasons for the fusion of the foreskin and the head of the penis in boys. Sometimes a fused genital organ is detected in newborns - this can be caused by a difficult pregnancy or infection of the child in the womb.

What do synechiae look like in a girl?

It is possible to determine that a girl has fused labia minora, and a boy has fused the foreskin with the head of the penis using a visual examination. This procedure should only be carried out with clean hands and trimmed nails. Otherwise, you can introduce infections into the baby’s genitals or injure the delicate skin of the perineum.

If the genital organ looks like a narrow strip, and the labia do not move apart, the baby most likely has fused them. In some cases, sticking of the labia majora is observed. In the schematic photo you can see what this phenomenon looks like.

Signs and symptoms of the disease

At the initial stage, synechia does not cause any discomfort to the child. However, subsequent stages of this pathology have pronounced symptoms. The following signs indicate that the labia are partially or completely overgrown:

• redness on the perineum;
• rashes on the genitals;
• inflammation of the mucous membranes;
• slow urination, which is accompanied by grunting, straining and crying;
• change in the direction of the urine stream (in boys it is directed upward);
• crying during hygiene procedures, especially when touching the perineal area, which indicates the appearance of painful sensations in the child;
• involuntary loss of urine.

If these symptoms appear, you should definitely show your baby to a doctor. If the size of a girl’s synechiae does not exceed 5 mm, there is no need for treatment.

But in any case, parents need to constantly monitor this phenomenon and see a pediatric gynecologist. With significant fusion of the vulva, discharge accumulates in the vagina and pathogenic microflora develops, which ultimately leads to an inflammatory process and, over time, to an infectious disease. In the future, such complications often cause infertility.

How to treat a child?

Synechia can be of 2 types: complete and incomplete. Treatment of the disease depends on the nature of the vulvar fusion. In the case of minor adhesions that do not affect the physiological processes in the body, the problem can be easily solved by proper hygiene. If a girl has fused large areas of her labia, and the situation continues to worsen, she cannot do without the help of a doctor.

The problem of vulvar fusion is solved by two methods: conservative or surgical. In the first case, treatment mainly takes place at home, but under the supervision of a pediatrician or pediatric gynecologist. Before deciding on a treatment plan, the doctor finds out the cause of the disease. For this purpose, the following diagnostic studies may be prescribed:

Depending on the nature of the symptoms, consultation with other specialists (for example, an allergist) may be required. Treatment begins only after identifying the causes of synechiae and making a final diagnosis.

Treatment at home

For minor fusion of the labia, medications that contain the hormone estrogen should be used. Such means include:

Synechiae can also be treated using traditional medicine (we recommend reading:). However, this should only be done after consulting a doctor. Methods for eliminating labia adhesion that are based on the use of natural ingredients include:

• potato juice - the fused area with the perineum is carefully stretched and lubricated with sterile cotton wool soaked in juice;
• baths based on a decoction of chamomile, calendula or string - the child must be seated;
• applications made from olive or sea buckthorn oil.

If the development of the adhesive process was triggered by an allergy, the baby is prescribed antiallergic drugs (Diprazin, Bravegil).

When diagnosing diseases of the genitourinary system, antimicrobial agents, antibiotics or antimycotics (Viferon, Sumamed) are used. It is forbidden to use any medications on your own, as this can only worsen the child’s condition. As an additional method of treating vulvar adhesion, after applying the cream, you can gently massage the area of ​​adhesion.

Surgical intervention

Surgical intervention is resorted to in severe cases of fusion of the labia in girls or in cases of ineffectiveness of conservative methods of therapy. Separating the labia minora and labia majora is not a complicated procedure. The manipulation takes only a few minutes and is performed under local anesthesia.

The operation is performed by a pediatric gynecologist. The dissection procedure does not pose a risk to the baby’s health and does not cause her pain. After cutting the fusion site with a scalpel, the wound is treated with a disinfectant solution, and after 20-25 minutes the mother and child can go home.

After the operation, for a certain period of time, you need to treat the perineal area with special creams, ointments or regular vegetable oil. To speed up wound healing, soothing baths based on decoctions of chamomile, calendula, sage, and string are also recommended. The operation cannot protect the child from re-fusion of the labia minora, but in severe situations and with complete fusion, dissection is the only way to help the child.

To avoid relapse of the disease, preventive measures should be followed:

1. You need to wash your baby properly. The washing technique plays a big role - always from top to bottom, otherwise you can introduce an infection into the vagina. To prevent dryness of the mucous membranes of the perineum and leaching of beneficial microflora, the child should be washed daily without using soap or other cosmetics; it is forbidden to use a washcloth, the rough structure of which can injure the delicate skin of the perineum.
2. Diapers need to be changed every 3 hours, with periodic ventilation of the child's genitals.
3. The child's underwear should only be made from natural fabrics. It is very important that things fit in size, otherwise the folds in the underwear will rub the perineum, which will eventually lead to the appearance of synechiae. Before putting things on the baby, they need to be steamed with an iron.
4. Children's clothes should be washed separately from the clothes of other family members and rinsed thoroughly.
5. If your baby is prone to developing allergies, you need to exclude allergenic foods from your diet. If redness appears in the labia area, it is necessary to generously lubricate them with baby cream or anti-diaper rash ointment.
6. You should not overuse sitz baths based on medicinal herbs and potassium permanganate.
7. Women during pregnancy, starting from the third trimester, are recommended to treat late toxicosis, as it often leads to the development of pathologies in children.

What should parents do if their daughter is diagnosed with synechiae, says famous pediatrician Evgeniy Komarovsky.

What it is

Synechia in girls is a cosmetic defect in an intimate place, in which fusion of the labia is observed in a certain fragment, usually in the lower third, or along the entire length. Not only the labia minora can be connected, but also the labia majora; in some cases, the labia minora are connected to the labia majora. Sometimes only the vagina is closed, and sometimes, with complete fusion, it is not possible to even see the openings of the urethra.

During the process of fusion, the child does not experience any pain, itching or other unpleasant sensations, and therefore even attentive parents find it quite difficult to understand when exactly this process began. Usually the diagnosis is faced with a fait accompli, when a pediatric gynecologist begins to talk about synechia after examining the child. As a rule, this happens when registering for kindergarten or school.

According to Evgeniy Komarovsky, 1-3% of all girls have this problem. This is only official data that exists mainly on paper. In practice, according to the doctor, the percentage of such babies in a single clinic can be close to 35-40%. This is due to how a particular doctor treats the signs of synechia: if you try very hard, fusion to one degree or another can be detected in almost every baby under the age of two years.

Thus, says Dr. Komarovsky, synechiae in girls should not be considered a disease. Rather, this is a physiological feature of early childhood, and there is nothing wrong with this diagnosis. This does not apply to cases where the fusion is so extensive that the outflow of urine is disrupted and obstructed. This can lead to serious gynecological inflammatory processes. In general, Komarovsky is sure that synechiae in early childhood do not have any effect on future reproductive function.

Causes

The reasons for the appearance of synechia in modern medicine are not yet completely clear, although many specialized reference books indicate some connection between the inflammatory process in the external reproductive organs and the subsequent fusion of the labia. So, the trigger for fusion can be bacterial inflammation or an allergic reaction.

Some gynecologists note that synechiae are more often formed in babies, whom caring parents wash with soap several times a day. With such hygienic procedures, the delicate skin of the labia is injured, and these microtraumas, healing, lead to fusion.

The synthetic clothes that the girl wears can also, according to doctors, lead to the formation of synechiae. An important role is also played by what kind of washing powder the mother uses to wash the child’s underwear - if it contains aggressive substances, synechiae can become a consequence of chronic inflammation to which the daughter’s genitals have been exposed for a long time due to chemical irritation.

One of the most convincing causes of synechia today is considered to be a low level of the female sex hormone estrogen in girls in the first years of life, and this is the norm. Newborn babies rarely suffer from fusion of the labia, since they have a sufficient supply of maternal sex hormones, but by six months the risk of synechiae increases.

Symptoms

The only, but quite obvious, symptom of synechia is a thin translucent film that connects the fused labia. Any doctor and almost all parents can see it if they look carefully. No tests or additional studies are needed to make a diagnosis.

If vulvitis or vulvovaginitis is added to the fusion, then redness will certainly be noticeable, discharge with an unpleasant odor may appear, and the girl will begin to complain of itching in the genital area.

Treatment

If the child does not complain about anything, if he is not bothered by pain, itching, or has problems with urination, then you don’t have to think too much about treatment, says Evgeniy Komarovsky. The degree of fusion needs to be monitored from time to time by visiting a gynecologist. There is no need to “rush” to surgery, because by the beginning of puberty, after 7 years, the girl will begin to produce female sex hormones (estrogens), and under their influence, the labia will become more elastic, and the problem with fusion will be solved by itself. This outcome occurs in approximately 80% of girls.

The rest will be prescribed drug treatment during adolescence - an ointment containing estrogen (Ovestin), which will need to be rubbed into the labia for several weeks. Gradually, the medicinal cream is replaced with any neutral one that does not contain perfume additives or dyes. It is used after bathing.

The standard treatment regimen looks like this:

• for the first 2 weeks, “Ovestin” is rubbed twice a day;
• for the next 2 weeks, rub the ointment once a day; for the second treatment, use regular baby cream;
• in the future, Ovestin is canceled, only baby cream or another neutral cream is left, provided that the synechiae have separated.

The drug should be rubbed in a strictly defined way: only with your finger, not with cotton wool or sticks, and only on the area of ​​the fusion, avoiding contact with adjacent areas. You need to apply the ointment with slight pressure, but at the same time make sure that the child is not in pain. Pressure is no less important than Ovestin itself.

Such effects are usually not observed when using ointments and creams with estrogen; only a small number of small patients may experience slight swelling of the labia. It disappears with further use.

Synechiae that are accompanied by problems with urination, unhealthy vaginal discharge, and pain should be treated immediately. Parents should remember well that even in such situations no one forces them to immediately take their child to a surgeon. First, therapy with the use of special estrogen-containing ointments is necessary, and only if it turns out to be ineffective, the child will be shown mechanical separation of the fused labia.

Evgeniy Komarovsky urges mothers not to agree to mechanical separation of synechiae manually - this is exactly what pediatric gynecologists often suggest doing. If your doctor is one of them, it is better to find another doctor who knows that in the 21st century it is better to use tools rather than fingers, and that the girl should definitely numb her labia first.

After a correctly performed procedure, Dr. Komarovsky recommends taking a course of using estrogen ointment to avoid re-union. According to medical statistics, the probability of relapse after labia separation surgery is about 30%.

To avoid re-fusion, or to prevent primary synechiae, the girl’s parents should remember that:

• You need to wash the baby under running water from front to back, and not vice versa;
• baby soap should be used no more than once a day, and it is important to ensure that it does not get on the mucous membranes of the labia and vagina;
• Children’s linen and bedding should be washed exclusively with baby powder; after washing, it is best to do an additional rinse with water that has previously been boiled and thereby “removed” chlorine;
• after water procedures, as well as swimming in a river, sea or pool, the girl must wear dry, clean underwear and panties;
• a baby who has not yet learned to go potty needs to change disposable diapers more often, make sure that there is no contact with feces and prolonged contact with urine;
• Panties should be purchased exclusively from cotton, white, without textile dyes.

Dr. Komarovsky will tell you more about synechia in girls in the next video.

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How to treat and prevent synechiae in girls?

Synechiae, or adhesions, are most often observed in little girls.

Most often, doctors make this diagnosis between the ages of 1 month and 3 years.

If symptoms of the disease appear, you should immediately contact a specialist. Thanks to this, treatment of synechiae in girls at home will be effective.

Description of the pathology

By this term, experts understand the adhesion or fusion of the labia minora or majora. This may occur throughout the entire perineum or affect only a third. In this case, there is no entrance to the vagina.

The labia are connected by a thin membrane. If complete fusion is observed, the urethral opening cannot be seen.

According to statistics, the peak of this disorder occurs in 2 age groups – 1-3 years and 7-8 years. In this case, the labia minora most often grow together. However, sometimes they are observed to be combined with larger ones.

This condition can be easily determined by performing a detailed inspection:

• the labia are connected by a light gray film;
• when the girl's lips are pulled apart, pain occurs, while the adhesive remains;
• It is possible to visualize only part of the vagina or it is completely closed.

In a normal state, the gap between the labia during dilution is quite large. In this case, the vagina can be examined unhindered.

Pediatrician Plus - Synechia (fusion of the labia minora) in girls

Causes

Before treating this disease, it is necessary to determine the causes of its occurrence. The main factors include the following:

1. Violation of hygiene rules. Most often, this problem appears when washing frequently - several times a day with soap. Children have an extremely thin mucous membrane of the genital organs, so it can be easily injured. When the damage heals, the lips grow together, which leads to the appearance of synechiae.
2. Infectious lesions of the genitourinary system. In this case, inflammation affects not only the urinary tract, but also the genitals. The entry of bacteria into the mucous membranes leads to inflammatory processes and fusion. A child can become infected with the infection during childbirth or through household contact.
3. Allergy. Often, rashes and other manifestations of allergies are localized on the mucous membranes. In girls with exudative diathesis, the vulva often turns red. This increases the risk of developing pathology.
4. Complications during pregnancy. Often, pathology is detected in children whose mothers had severe toxicosis or infections during pregnancy. In such a situation, it is very important to undergo a timely examination by a pediatric gynecologist.
5. Hormonal imbalance. Estrogen deficiency and increased sensitivity of the labia in young girls is normal. However, these features can lead to the appearance of synechiae. In such a situation, there is no need for treatment, since by 6-8 years the adhesions will disappear.
6. Frequent colds, infectious diseases, incorrect choice of diapers, use of antibiotics. All these factors can also cause similar problems.

Symptoms

Synechia is accompanied not only by visual differences in the structure of the genital organs.

In addition, the following symptoms may occur:

1. Irritation often occurs on the girl’s genitals and thighs. They appear as redness of the skin. Sometimes peeling and rashes are observed.
2. The process of urination provokes pain. However, young children cannot always identify this symptom. Therefore, a girl’s refusal to go to the potty should prompt parents to pay attention to the appearance of the labia.
3. With partial fusion, urination does not cause difficulties. In this case, the anomaly leads to the fact that the flow of urine is directed upward.

In some cases, synechiae is accompanied by symptoms of infection. However, in most situations the disease is asymptomatic. Therefore, parents often discover it by accident when carrying out hygiene procedures.

Treatment

How to treat synechiae in girls? This question worries many parents. In the absence of severe symptoms, specific therapy is not needed. With an increase in estrogen levels in the body, the disease will go away on its own.

Hygiene

In simple cases of the disease, it is necessary to provide proper care to the girl’s genitals:

1. Wash morning and evening without using a washcloth. This should also be done after each bowel movement.
2. Do not use soap too often.
3. Apply the cream only as directed by a doctor.
4. Do not use antiseptics. They can only be used after consulting a specialist.
5. Buy underwear only from natural fabrics.
6. Change your underwear every day.
7. Take air baths if the child is in diapers all day.
8. Choose baby soap without additional ingredients. When using the gel, you need to take into account its acidity.

Folk remedies

Herbal baths and massage are used as a complement to hygiene procedures. When performing it, you must apply Bepanten to your finger.

Medicinal plants such as sage, calendula and chamomile are commonly used for sitz baths. The duration of each procedure should not be more than 10 minutes.

Then you should lubricate the genitals. Sea buckthorn or peach oil for synechia in girls will be an excellent option in this case.

When performing a massage, you need to use light strokes without pressure. In this case, movements should be directed towards carefully separating the labia.

To stimulate the recovery process, Bepanten ointment should be used. It is important to consider that you will not be able to achieve results immediately. Therefore, movements should be as careful as possible - this will help avoid discomfort.

Treatment of synechiae with folk remedies involves the use of simple recipes:

1. Squeeze the juice from the potatoes, then soak 2 cotton pads in it. Rub them over the area where the adhesions are located, gently stretching them to the sides.
2. Wash your hands well, take sunflower oil and dip your finger in it. Pass in the area of ​​the commissure, gently pressing on it. It is important that the child does not feel discomfort.

Such procedures can be done with a partial form of pathology, which is not accompanied by complications. Before using any product, you need to consider the risk of allergic reactions.

If you are intolerant to sea buckthorn or peach oil, you can use olive oil.

Medications

If pain occurs, standard therapy should include the use of special ointments with estrogens or ordinary children's creams.

The first category of drugs should not be used without medical advice, although they cause minimal side effects. The ointment should be applied precisely along the line of adhesions, trying not to touch the rest of the genitals.

The standard duration of therapy is 2 weeks. In this case, it is recommended to use the drugs twice a day.

The doctor should then evaluate the results and, if necessary, prescribe another course of therapy. However, in this case, the ointment is applied once a day.

In addition to ointments with estrogen, regular baby cream is used. They should clean the baby's genitals after bathing. A good option would be Malavit cream gel, which has a soothing effect on the skin.

The most commonly used ointment is Ovestin, which in most cases successfully treats synechiae. This drug is an analogue of estrogen.

Gradually, the drug is replaced with a regular cream containing lanolin, which will become a reliable prevention of re-formation of adhesions.

Ovestin for synechiae in girls is applied once a day before bedtime. Therapy with this remedy has certain features that must be taken into account in order not to damage the mucous membranes of the genital organs:

1. It is forbidden to put pressure on fused organs or try to separate them.
2. The ointment should be applied in a thin layer. To do this, apply 5 mm of the product to a clean finger and treat the synechiae, performing gentle rubbing movements.
3. The drug is absorbed quite quickly and is eliminated after about 18 hours. Therefore, it is enough to use it once a day.
4. After completion of therapy, the synechiae will completely disappear. However, Ovestin should continue to be used for prevention.
5. The duration of treatment with this drug is 20 days. Then you need to take a break for 10 days.

For people who are afraid to use hormonal ointments, the doctor can choose alternative remedies. Contractubex for synechia in girls should be mixed with the drug Traumeel.

These substances are taken in the same ratio and applied to the adhesions. Treatment should be continued for 3 months. Methyluracil ointment can be prescribed for the same purposes.

Prevention

How to prevent synechiae in girls? This question worries many parents. Prevention of this disorder includes the following components:

• exclude products that can provoke allergies;
• wash the child in the morning, in the evening and after each bowel movement, making sure the perineum is clean and dry;
• When washing, do not place the girl in the bathtub or basin; wash the genitals very carefully in the direction of the anus;
• You can wash the perineum with a clean hand with short nails;
• use intimate hygiene gel instead of baby soap;
• do not use wet wipes, cosmetic creams and powders unless the doctor gives other recommendations;
• bathe the girl in clean water without the use of antiseptics and aromatic additives;
• Use baths with medicinal plants only as prescribed by a doctor.

If synechiae occurs in a girl more than once a year and is accompanied by redness, itching or discharge, it is very important to undergo a bacteriological culture or vaginal smear. Thanks to timely therapy, it will be possible to prevent relapses of the pathology.

Synechiae is considered a fairly common problem that can cause serious discomfort in young girls.

To avoid such problems, you should promptly consult a doctor who will select adequate therapy. Folk remedies can be used as a complement to traditional treatment.

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Use of Ovestin for synechiae in girls

How is pathology diagnosed?

Synechia in girls can be easily determined upon examination; the presence of pathology is indicated by the following signs:

• The labia are connected by a thin film of light gray color
• By spreading the labia apart, the girl experiences painful sensations, but the adhesion does not disappear anywhere
• Upon examination, the vagina is visualized as partially or completely closed.

Normally, when the labia are separated, a fairly large gap is observed; a detailed examination of the vagina can be performed.

How is the treatment carried out?

In the absence of characteristic signs of pathology, there is no need for special therapy. With a gradual increase in estrogen levels in the baby’s body, everything will go away on its own.

Hygiene rules

Parents must provide proper hygienic care for the girl’s genitals, namely:

1. Carry out washing twice a day (morning and evening). It is necessary to carry out this procedure after defecation.
2. Do not use soap very often to wash children.
3. Use ointments and creams only after prescription by a pediatric gynecologist.
4. Avoid using antiseptics.
5. Buy your child underwear made exclusively from cotton and change it daily.
6. After each diaper change, allow the skin to “breathe.”
7. Use soap without any additives for washing.

In some cases, you cannot do without using cream. The use of Ovestin for synechiae in girls is quite effective. Although it contains hormonal components, it effectively fights fusion of the labia minora. Parents who have used this drug talk about the ease of use and quick results during treatment.

How to use Ovestin cream

The hormonal agent Ovestin should be applied along the adhesion line, without affecting the genitals. The standard course of treatment with Ovestin usually does not exceed 2 weeks. (if the pathology has not been treated previously), treatment of adhesions is carried out twice a day.

After the course of treatment is completed, you will need to take the child for an examination to evaluate the results of hormone therapy. If necessary, a specialist may recommend continuing to use the cream, only now the ointment is applied to children once a day.

Treatment also involves the use of regular baby cream, which should be applied immediately after bathing.

Features of hormonal cream therapy

It is necessary to treat synechiae in girls taking into account a number of rules so as not to injure the mucous membranes of the external genitalia:

• You cannot remove synechia yourself by separating the labia minora.
• The ointment is applied in a thin layer, followed by rubbing in the areas where adhesions form.
• After the synechiae resolve, you will need to continue using an estrogen-containing product for prevention purposes.

Contraindications

Ovestin is a hormonal drug, so there are a number of contraindications to its use:

• Intolerance to drug components
• Presence of estrogen-dependent neoplasms
• Bleeding from the vagina of unknown origin
• Current or previous presence of thromboembolism
• Porphyria
• Active liver diseases
• Changes in liver test parameters.

Adverse reactions

The development of side symptoms during treatment of synechiae in a child should not be ruled out.

It should be noted that during use of the cream, local irritation and itching may be observed (the child scratches the mucous membranes of the perineum).

Common adverse reactions include nausea and slight tenderness of the mammary glands. In rare cases, headaches and a sharp increase in blood pressure are possible.

Remember: preventing the development of pathology is much easier than treating it in the future. Take care of the health of your own children!

Synechia (fusion) of the labia minora in girls: how can a mother recognize the problem and solve it?

Synechia, or sticking together of the labia minora, occurs in early infancy or somewhat later, before the age of six. Often the disease is asymptomatic and is discovered by parents while caring for the child or by a doctor during a medical examination. Determining what synechiae look like is not difficult in most cases. This can be done by carefully examining the genitals.

The disease is prone to constant recurrence. In approximately a third of patients, new adhesions appear.

How to conduct an inspection

Before the examination, you should thoroughly wash your hands with soap and cut your nails so as not to injure the delicate skin. Spreading the child's legs, carefully examine the genitals. In this case, pay attention to the presence of a genital slit through which the vagina is visible.

If instead of a slit only a whitish stripe is visible, and an attempt to part the labia minora does not bring success, there is a high probability of synechiae. In rare cases, fusion of the labia majora occurs.

Signs of pathology

Synechiae of the labia minora may not cause discomfort to the girl. In some cases, problems with urination are observed; when wanting to urinate, the child begins to grunt, strain hard and cry. After urination, immediate relief occurs.

The following symptoms can also be identified:

• redness of the skin in the genital area, the appearance of a rash;
• irritation of mucous membranes;
• crying indicating pain when touched while washing or bathing;
• the direction of the urine stream is upward, which is typical for boys.

In girls 1 year of age and older, urine leakage occurs, even if the child is already using the potty.

How dangerous is the disease?

The fusion of the labia cannot be regarded as a natural process that should not be paid attention to, but its occurrence rarely brings serious consequences for the female body.

However, the condition can contribute to the development of various infectious processes. With the progression of the disease in the future, associated with the growth of the genital organs and improper formation of the perineum, the girl may have problems with conception and delivery.

The initial stage of the formation of synechiae makes itself felt by swelling of the vulva, its redness, irritation, and pain when urinating. If you suspect a pathology, you need to take your child to a doctor.

Synechia is an insidious disease prone to relapse. Girls under one year old cannot rely on their independent resolution. The problem can be eliminated by puberty. With this pathology, the child should be under the supervision of a pediatric gynecologist, who will determine the necessary treatment and give recommendations on the care of the genitals.

Causes of fusion

The reasons for the formation of synechiae may be different. If they are noticeable even in a newborn, then they were most likely caused by a complicated pregnancy and intrauterine infection of the fetus.

In preschool age, adhesions in girls may appear for the following reasons:

• previous infectious diseases of the genitourinary area (cystitis, vulvitis, vulvovaginitis), when bacteria penetrate into the site of inflammation, which provokes fusion of the labia minora;
• transmission of viruses through household means (through towels and other care items);
• improper genital hygiene, use of aggressive cosmetics that eliminate the necessary bacterial environment;
• tendency to allergies as a result of skin contact with residues of washing powder on linen, sanitary wet wipes, diapers, leading to swelling of the vulva and the further appearance of synechiae;
• hormonal imbalances caused by estrogen deficiency;
• wearing underwear made of low-quality synthetic materials;
• helminthic infestations, intestinal discbacteriosis, taking certain medications.

Treatment

Synechiae can be incomplete or complete. If the fusion occurs in a small area of ​​the labia minora, the problem can be solved by following the rules of hygiene and care. A great danger is the complete fusion of the labia minora, which can only be cured with timely consultation with a doctor.

Before determining treatment, the patient is prescribed general blood and urine tests, a smear is taken for bacterial culture from the vagina or tests for hidden infections.

If synechiae is caused by allergies, consultation with an allergist is required.

Local therapy

Ointments and creams containing estrogen are used in treatment.

A hormonal agent used for various diseases associated with estrogen deficiency. The main active ingredient is estriol.

Treatment with Ovestin is carried out for 20 days, then take a short break of 10 days. After a break, the course is repeated. Ovestin is recommended for use no more than once a day. It is better to treat synechiae before the child goes to bed. If the baby sleeps in a diaper, it should not be put on until the cream is completely absorbed.

In some cases, negative reactions are possible: vaginal itching, mucus secretion, skin rashes. The cream should be prescribed with caution to patients with bronchial asthma, epilepsy, and liver diseases.

The ointment is applied in a thin layer. The treatment is carried out with careful rubbing movements. You cannot put pressure on the genitals or try to separate the synechiae yourself. It is strictly forbidden to use various improvised means for this purpose, which can serve as a source of infection.

The cream is often prescribed for synechiae in girls. The optimal combination of active ingredients (onion extract, sodium heparin, allantoin) has a bactericidal effect, anti-inflammatory effect, and heals wound surfaces.

The product is applied to the fused area twice a day in a thin layer. A greater effect can be achieved by combining this drug with Traumeel S or Bepanten. The course of treatment is 20 days, then after a pause it is repeated. Since synechiae is a recurrent phenomenon, Contractubex can also be used for prophylactic purposes.

The drug has virtually no contraindications. The only obstacle to its use is increased intolerance or sensitivity to individual components.

Bepanten ointment or cream is effective if the disease is complicated by inflammation. Bepanten eliminates ulcers, cracks, and erosions of delicate skin. Its use prevents the development of infection.

Bepanten is a safe drug; it is suitable for both newborn girls and older children. The treatment is carried out after washing and thoroughly drying the genitals.

Baths with the addition of chamomile, calendula, and oak bark will help prevent relapse. When treating synechiae in girls at home, oils of plant origin (sea buckthorn, peach, almond, grape seed) are used.

Surgery

How to treat complete fusion if conservative treatment does not produce the expected results? In this case, a dissection is performed. The operation is performed under local anesthesia. The procedure is not dangerous and does not cause any discomfort or bleeding in the girl.

The operation takes only a few minutes. After the procedure, the wound is treated with an antiseptic solution and after a minute the girl and her mother can go home.

After surgical separation of synechiae, regular treatment of the genital organs is necessary for some time. For this purpose, both creams and ointments and vegetable oils are used. Regular baby cream will also work. Soothing baths based on decoctions of chamomile, calendula, sage, and string are prescribed.

You will have to treat small lips with cream for at least a month. In the future, this procedure is carried out once a week for the purpose of prevention.

Massage

This procedure belongs to the auxiliary methods of treating synechiae. Massage is done after applying the ointment. After waiting a minute or two until the cream-gel begins to be absorbed, begin massaging the glued labia. The movements should be smooth, careful, but slightly pressing.

If fusion is not complete, you can try to gently separate the lips, but you should not overdo it. It is undesirable to make sudden movements, especially when trying to separate glued lips, as movements can cause injury or psychological discomfort in the child.

The following home remedy has worked well. Wipe the affected area with a cotton pad soaked in potato juice, trying to slightly stretch the labia in different directions. The procedure must be regular. Thus, in case of incomplete fusion, surgical separation can be avoided with the help of a kind of massage.

Prevention of synechiae in girls

Unfortunately, the phenomenon of synechiae is prone to repeated “returns” even after surgical separation. The problem is solved only with the onset of puberty. Preventive measures, compliance with hygiene rules and daily routine will help significantly reduce the risk of relapse. So, prevention includes following the following rules:

1. You need to wash your child with regular tap water without using soap or other cosmetics that dry out the vaginal mucosa and wash away beneficial microflora.
2. Don't get carried away with bubble baths, if you can't give them up completely, add it just before finishing your bath.
3. The choice of underwear should be made in favor of models made from natural cotton. Only in such panties will the skin breathe freely. You also need to make sure that the underwear does not squeeze or rub the skin, as this can provoke an inflammatory process.
4. Timely detect and treat infectious and viral diseases. In most cases, synechiae occur as a consequence of incorrectly and incompletely treated diseases.
5. Regular visits to a pediatric gynecologist. This recommendation often causes confusion among mothers who believe that a little girl has no business being in a woman’s doctor’s office. However, doctors advise visiting a gynecologist already in preschool age.
6. Changing diapers in a timely manner; in some cases, you will have to stop using them; it is better to wash preschool children’s clothes separately from the clothes of adult family members.
7. Choose commercial detergents and cosmetics, toilet paper and other care products without artificial dyes and fragrances.
8. Preventive use of ointments with estrogen in those girls who have previously been diagnosed with genital fusion. The dosage and duration of treatment is determined by the doctor!
9. Pregnant women in the third trimester should actively combat the manifestations of late toxicosis (protein in the urine, edema, high blood pressure), as these symptoms lead to complications during childbirth and the appearance of pathologies in the newborn.

Synechia of the labia (vulva) – connection of the labia majora and minora throughout or partially with soft and elastic connective tissue, which is formed in girls for various reasons: inflammation, certain hormonal levels, improper hygiene, etc.

The peak incidence occurs in 2-3 years of age. The initial manifestations of the disease are subtle and do not cause discomfort to the baby, so most people seek medical help late.

Treatment of synechiae is both conservative and surgical - everything is determined by the clinical picture.

This pathology occurs in approximately 1% of girls under 6-8 years of age (according to some studies, synechia of varying degrees occurs in 30% of girls). With the onset of puberty and in the first two years of life, synechiae of the vulva are extremely rare.

Reasons for the development of pathology

True the cause of formations in girls has not been identified. There are many assumptions about the nature of this disease. Suggested factors in the development of synechiae:

Hormonal background

The arguments are confirmed by the fact that the frequency of synechiae increases sharply in girls from 1.5 to 6-8 years. In the first year of life, the baby receives female sex hormones - estrogens - from the mother in utero, and then through breast milk. And from 8-10 years of age, the ovaries begin to increase their own estrogen production. Consequently, the peak of the disease occurs precisely during the period with a minimum amount of estrogen.

Also confirming this theory is the fact that synechiae are very successfully treated with ointments containing estrogens - female sex hormones.

Inadequate genital hygiene

Synechiae can form both with insufficient hygiene and with its excess.

The use of any intimate hygiene products on a child is unacceptable. The soap used should not contain excess dyes and fragrances. A proven option is baby soap without additives (even if it says it contains sage or chamomile) or homemade soap.

Modern children often suffer from allergic reactions or, at a minimum, increased sensitivity to flavors, dyes and other substances. Just like excessive hygiene, this will lead to thinning of the skin in the genital area and the disappearance of beneficial microflora of the perineum. As a result, the skin becomes vulnerable, traumatic, and inflammation easily occurs. And the presence of an infectious process directly contributes to the formation of synechiae.

In contrast to this flaw hygienic procedures leads to the entry of pathogenic flora into the vagina, for example, from the rectum. Inflammation occurs, and the delicate skin of the labia first sticks together, and then a delicate membrane is formed that connects them.

Any urinary tract infections

Urinary tract infections (UTIs) can cause synechiae to form. Together with urine, pathogenic microorganisms settle on the skin of the perineum and vulva, causing inflammatory changes there as well. Urethritis and pyelonephritis often lead to this.

UTI may develop as a result of the formation of synechiae, or changes in urine may be false due to the presence of vulvar adhesions. In the first case, the outflow of urine is disrupted due to the fact that the external opening of the urethra is covered by the labia minora welded together. In the second case, leukocytes will always be elevated in a general urine test, since they will enter it from the inflamed vulva.

Sexual infections

Despite the fact that the girl is not sexually active, she may be diagnosed with an STI - a sexually transmitted infection. This is because many STIs are also transmitted by by contact– through washcloths, towels, underwear, etc.

The most common infections that can cause synechiae are: gonorrhea, syphilis, trichomoniasis. As a rule, infection occurs from the mother. That is why the mother should be examined by a gynecologist together with her daughter. STIs lead to the development of specific vulvitis (inflammation of the vulva only) and vulvovaginitis (inflammation of the vulva and vagina).

Other infections

Tuberculosis of the external genitalia stands out separately. It is rare. In 95% of cases it is combined with tuberculosis of other organs, most often the lungs. Tuberculosis is a contagious disease. Usually synechiae tuberculosis etiologies occur in families where there are still patients with this disease.

Allergic reactions

Allergies can manifest themselves both to hygiene products and to linen (especially colored and synthetic), powder and fabric softener, diapers, etc. When such increased sensitivity occurs, the baby develops constant itching and she scratches these areas. The result is secondary infection and the development of synechiae.

Complications of pregnancy and childbirth

A pattern has been revealed: in girls whose mothers suffered from gestosis during pregnancy(swelling, changes in urine analysis, increased blood pressure), genital tract infections synechiae occur an order of magnitude more often. There is also an increased risk of adhesions in the vulva in children with congenital intrauterine infection and premature infants.

Injuries to the external genitalia

Improper hygiene measures and improper care of injured areas of the genital organs also lead to synechiae.

Chronic diseases

Some endocrine diseases can provoke the development of synechiae due to changes in the properties of the skin. More often it is sugar diabetes(especially poorly compensated), hypothyroidism(underfunction of the thyroid gland).

In these situations, increased dryness of the skin and the appearance of microcracks are observed. And glucose metabolites in diabetes mellitus, being excreted through the skin, provoke the proliferation of pathogenic microflora, especially in places with active sebaceous and sweat glands.

Symptoms of the disease

It is difficult to identify the initial stage of the disease at home on your own. The girl may not be bothered by anything. Traces are often found on laundry yellow or greenish discharge is a sign of inflammation.

With an allergic nature, the skin of the entire perineum will be changed - this redness, rash, combs, small bubbles with light liquid. Mom may notice constant scratching of the genital area, buttocks and anus. Sometimes a child may complain of pain in the vulva area.

As the disease progresses, the girl may experience soreness process urination. The child will try in every possible way to avoid going to the toilet again, and small children will be afraid of the potty. At the moment of urination, the girl may strain and strain, blushing at the same time.

When carefully examining the baby's genitals Can notice thin whitish film, which glues the labia minora partially, for example, 1/3, or completely, while closing the entrance to the vagina and urethra. Sometimes the labia majora are also involved in the process.

Synechiae can occur between the labia majora and labia minora. Then, upon examination, it is clear that the skin of the small lip is “glued” to the large one. If the mother tries to separate the child’s labia, it causes pain, the girl is restless and may cry.

Diagnostics

Parents may suspect the disease, but only an experienced obstetrician-gynecologist can definitively confirm it. A thorough visual examination helps make the diagnosis. How to identify the cause:

Sometimes you have to resort to a more in-depth examination as recommended by your doctor.

Prevention of disease

Parents should try to reduce the risk of developing synechiae as much as possible:

It is correct to wash your baby from front to back! For genital hygiene, there is no need to use washcloths and other devices - you need to do this with your hands.

Consequences

Synechiae that is not detected in time in a little girl can lead to improper formation of the baby’s genital organs, then there is a possibility of problems with childbirth. A constant inflammatory process in the vulva area can lead to the spread of infection to the vagina, uterus and appendages. Difficulty urinating will provoke the development of diseases of the urinary system - cystitis, urethritis, pyelonephritis.

Treatment

If we imagine the treatment process as a sequence of actions as the process worsens or treatment becomes ineffective, it will look like this:

1. Observation and correct hygiene measures.
2. Using herbal decoctions in bathing water.
3. Using regular creams.
4. Use of hormonal ointments.
5. Surgical separation of adhesions.

Therapy should be prescribed after examination by a pediatric gynecologist. Only he can decide whether the girl needs surgical treatment, or whether the disease can be dealt with without the use of a scalpel.

Conservative treatment takes place at home according to strict doctor's recommendations. Some obstetricians-gynecologists are convinced that one should always start with drug treatment, and if ineffective, resort to cutting adhesions. They motivate their position by the fact that the risk of relapse after only surgical treatment reaches 80% .

Conservative treatment

It is most effective and is used in cases where synechiae covers a small area on the labia. The emphasis in conservative treatment is on compliance everyone hygiene rules in a girl (see details in the “Prevention” section).

After taking water procedures, you must carefully dry the genitals and lubricate the labia with a rich baby cream containing lanolin.

Sea buckthorn oil and glycerin, peach oil and others are suitable. Into the bathing water You can add a decoction of St. John's wort, chamomile, and calendula. In such cases, prepare the infusion in advance and allow it to fully prepare for 8-10 hours, and then add it to the water when bathing.

Many gynecologists believe that nothing else needs to be done, and in such cases choose observational tactics in treating the baby. Often used in treatment creams and ointments, containing female sex hormones– estrogens.

The most popular drugs are Ovestin, Colpotrophin. These drugs soften and loosen synechiae. Therapy with hormonal ointments usually continues for 2-3 weeks, with results assessed once every two weeks.

Scheme for using the cream and application rules

Over the next two weeks, it is prescribed to lubricate the fusion site once with ointment, and a second time with lanolin-based baby cream.

After two weeks of such treatment, you should switch to using only the cream, with the aim of preventing relapse.

It is correct to apply the cream or ointment with your finger strictly along the line of the lip fusion, lightly pressing on this area, as if trying to separate it. However, such exposure should not bring the slightest concern to the child.

Some parents are wary of using estrogen-containing creams in young children, fearing systemic effects and the development of premature puberty. However, these prejudices are in vain. As a rule, the course of therapy is short and complications do not occur in most cases.

However, the use of ointments with estrogen should be under the supervision of an obstetrician-gynecologist, who regularly examines the baby’s mammary glands for engorgement, and also monitors hair growth in areas where hair growth is observed only from the moment of puberty - the armpits, pubis. The color of the skin in the armpits, inner thighs and genitals is also assessed.

If any systemic manifestations are detected, discontinuation of estrogen therapy leads to the return of the baby’s body condition to its previous state.

To avoid complications It is recommended not to use hormonal treatment in girls less than one year old. For unexpressed synechiae, you can use contratubes instead of hormonal ointments. The cream has fibrinolytic, anti-inflammatory and absorbable effects. It is useful to use it in a mixture with another homeopathic cream - Traumeel S. The creams are mixed in equal proportions and applied using the same method as hormonal ointment.

In more complex situations, pediatric gynecologists recommend using creams in combination with estrogen-containing ointments. If your baby develops a rash, itching, or redness at the site where the cream was applied, you should consult a doctor - this may be an allergic reaction to the components of the drug.

Genital massage for synechiae

The algorithm is as follows:

1. Spread the fusion area apart with your thumb and index finger.
2. Using the finger of your other hand, use gentle pressing movements along the fusion site.

It is useful to use this technique while applying a medicinal cream - this way the recovery process will go faster.

Surgery

Dissection of labia fusions is performed in the following cases:

1. With full involvement of the labia in the process.
2. In the absence of effect from hormonal therapy.
3. If there is a violation of the outflow of urine.
4. If it is determined that synechiae is the cause of serious inflammation of the urinary tract.

Surgical treatment can be performed on an outpatient basis or in a hospital at the discretion of the doctor. The procedure is performed under local or general anesthesia - depending on the severity of the process and the scope of the intervention.

There are many techniques for dividing synechiae; the preference for one or the other is made by an obstetrician-gynecologist.
Surgical treatment is always combined with subsequent conservative treatment according to the methods described above.