Comparison of estrogen and betamethasone in the topical treatment of labial adhesions in prepubertal girls

To compare estrogen and betamethasone in the topical treatment of labial adhesions in prepubertal girls. Materials and methods: In this retrospective study, we evaluated 39 girls with labial adhesions covering at least 50% of the vaginal opening. Of the total patients, 20 were treated with a topical estrogen preparation, while the remaining 19 patients were treated with a combination of betamethasone cream and petroleum ointment (Vaseline) for 3 to 9 weeks. Results: Sixteen of 20 (80%) patients in the estrogen treatment group were treated successfully with topical estrogen cream only, and 17 of 19 (89.4%) patients in the second group were treated successfully with a combination of betamethasone cream and petroleum ointment. Two patients (2/20) in the estrogen treatment group underwent a surgical procedure for the manual separation of the labial adhesion. One patient (1/19) treated with betamethasone cream and petroleum ointment required a manual separation procedure. We observed a side effect of labial enlargement in 2 patients (10%) who were treated with estrogen only, while the only side effect of the betamethasone treatment was local irritation, which occurred in a single patient (5.2%). In addition, the success rate of the betamethasone treatment exceeded that of the topical estrogen (89.4% and 80%, respectively). Conclusion: Betamethasone cream with petroleum ointment is a safe and effective primary therapy for prepubertal labial adhesions.

Anahtar Kelimeler:

Labial adhesions, betamethasone, estrogen

Comparison of estrogen and betamethasone in the topical treatment of labial adhesions in prepubertal girls

Keywords:

Labial adhesions, betamethasone, estrogen,

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Leung AKC, Robson WLM, Kao CP, Liu EKH, Fong JHS. Treatment of labial adhesion with topical estrogen therapy. Clin Pediatr 2005; 44: 245–247.
Valender MH, Mikkelsen DB, Bygum A. Labial agglutination in a prepubertal girl: effect of topical oestrogen. Acta Derm Venereol 2009; 89: 198–199.
Muram D. Treatment of prepubertal girls with labial adhesions. J Pediatr Adolesc Gynecol 1999; 12: 67–70.
Mayoglou L, Dulabon L, Martin-Alguacil N, Pfaff D, Schober J. Success of treatment modalities for labial fusion: a retrospective evaluation of topical and surgical treatments. J Pediatr Adolesc Gynecol 2009; 22: 247–250.
Myers JB, Sorensen CM, Wisner BP, Furness PD 3rd, Passamaneck M, Koyle MA. Betamethasone cream for the treatment of pre-pubertal labial adhesions. J Pediatr Adolesc Gynecol 2006; 19: 407–411.
Soyer T. Topical estrogen therapy in labial adhesions in children: therapeutic or prophylactic? J Pediatr Adolesc Gynecol 2007; 20: 241–244.
Elmore JM, Baker La, Snodgrass WT. Topical steroid therapy as an alternative to circumcision for phimosis in boys younger than 3 years. J Urol 2002; 168: 1746–1747.
Chu CC, Chen KC, Diau GY. Topical steroid treatment of phimosis in boys. J Urol 1999; 162: 861–863.
Tebruegge M, Misra I, Nerminathan V. Is the topical application of oestrogen cream an effective intervention in girls suffering from labial adhesions? Arch Dis Child 2007; 92: 268–271.
Schober J, Dulabon L, Martin-Alguacil N, Kow LM, Pfaff D. Significance of topical estrogens to labial fusion and vaginal introital integrity. J Pediatr Adolesc Gynecol 2006; 19: 337– 339.
Sanfilippo JS. Labial adhesions. In: Behrman RE, Kliegman RM, Jenson HB, editors. Nelson Textbook of Pediatrics. 16th ed. Philadelphia, PA, USA: Saunders; 2004. pp. 1829–1830.
Opipari AW Jr. Management quandary. Labial agglutination in a teenager. J Pediatr Adolesc Gynecol 2003; 16: 61–62.
Aribarg A. Topical oestrogen therapy for labial adhesions in children. Br J Obstet Gynaecol 1975; 82: 424–425.
Arkin AE, Chern-Hughes B. Case report: labial fusion postpartum and clinical management of labial lacerations. J Midwifery Womens Health 2002; 47: 290–292.