Adhesion Removal for 2-year old girl?
Lisa has a specific question and wonders if anyone has gone through a similar experience:
I just came from my daughter's 2-year check-up and the doctor recommended getting an 'adhesion' removed from my daughter's genital area. The doctor examined my daughter and we were told that this thin lining may open up by itself but it can cause leaking of urine as she grows older because the opening is not completely open. I was astounded. I've googled and asked friends and no one has heard of this before. Fellow urbanMamas, help! I'm reluctant to do anything about this and let nature take it's course, but don't know anything about this subject.
I don't have any experience with it as mom to two boys, but here are a couple links for you.
http://www.drgreene.com/21_1130.html
http://www.drspock.com/article/0,1510,5892,00.html
http://www.babycenter.com/0_labial-adhesion_10889.bc?Ad=com.bc.common.AdInfo%4067c4a583
http://www.keepkidshealthy.com/welcome/commonproblems/labialadhesions.html
Posted by: jj | October 24, 2007 at 03:29 PM
Was your doctor referring to her inner labia opening? That happened with my daughter, so her doctor prescribed estrogen cream, which was meant to help it open up. We applied it for quite a while, and I had thought it worked, until we had to take her to the ER one weekend. They needed to catheterize her to get a urine sample, but said her labia were still joined, and in the way. The nurse pulled it apart -- worst 15 seconds of my life. But, it didn't freak my daughter out, and she seemed to be just fine. No residual pain, no bleeding, etc.
So, if this is what your daughter is dealing with, I would say...the estrogen cream was easy, but I can understand not wanting to put hormone cream on your daughter. Not sure what other solutions your doctor might be thinking of. The manual separation was not as bad as I expected it would be, though I think I would have had a hard time agreeing to it had we not been in an urgent situation.
Hope that helps!
Posted by: Charissa | October 24, 2007 at 03:35 PM
My daugter had a labia adhesion also and our doctor prescribed the estrogen cream. You only use a small amount. It worked for her. I think it was first noticed at her 2 year appointment, but only slight. We moved and we didn't start the cream until I think she was 4 years. (she was having some potty accident issues, so we brought her in and had them do a check for bladder infection, etc and notice that it was quite closed.)
Posted by: Lisa | October 24, 2007 at 06:10 PM
My 2 yr-old has an adhesion of the inner labia that basically obscures her vaginal opening. We were floored as well to discover this at her 9-month appointment (our ped probably should have caught it earlier and we couldn't believe we didn't know, she had just always looked like that!) Our ped. thought we should have it opened and prescribed estrogen cream. My husband and I both agreed that we didn't want to expose her to the hormones (they can develop breast buds etc because of it). We did some medical lit searches and found that for cases like our daughter's, most of the adhesions open on their own later on (before or as they are entering puberty) and that actually, a number of times when they are manually opened, they re-adhere again anyway.
We went to see a pediatric urologist and he said he could open it, although even with a topical numbing med. that she would experience quite a bit of pain for a short period and that we would have to keep putting ointment on it and would perhaps have to do it again if it re-adhered. He agreed that in her case, it would probably open on its own. She is not experiencing any symptoms because of it. He supported our decision to do nothing at this time (but recommended coming back in if she ever has any issues with urinating or pain, etc.)
My main thought about the pain of manually separating the adhesion was that I could not conscience at this time and at this age (with no symptoms) causing her pain for something that could resolve on it's own. If she ends up needing to have the adhesion manually opened when she's older, I would feel more comfortable being able to explain the procedure to her and asking her to tolerate some discomfort when
she's better able to understand it, rather than possibly causing her fear and pain (and resistance to diaper changes or being wiped, etc when she's recovering) now. Just my opinion!
I don't know the severity of your daughter's case but I would recommend seeing a pediatric urologist for further evaluation. Perhaps there really is a physical blockage of the urine and opening it would relieve that. Let me know if you want the name of our doctor!
Posted by: Rasa | October 24, 2007 at 06:22 PM
Both my daughters had labial adhesions and they were not a big deal whatsoever. With my first, I noticed it when she was around a year or so. It scared me at first, I had never heard of them, so when I noticed her vaginal opening seemed to have closed up I rushed her to the doctor, wondering how in the world she was going to be able to pee.
He said it was really common and prescribed the estrogen cream. We were a little reluctant but used it because we didn't want it to interfere with her ability to urinate, at least comfortably. The cream worked in a couple weeks tops and had no side affects. I think her labia adhered a little bit again a while later after that but not as much and we used the cream again and it worked even faster. Once her hormones kicked in it was all history.
My youngest got her adhesion much earlier and it was much thicker. I was worried because it was so fused it actually looked like she had an abnormally small opening. So, even though I was an old pro at adhesions, I was worried this was something worse. Her pediatrician recommended taking her to a pediatric urologist to have it looked at. He immediately diagnosed it as an adhesion, numbed the skin and slit it open right then and there. She didn't even wince. No pain. No discomfort later. We had to put neosporin on it for a while, and pry it open at every diaper change and still it didn't seem to bother her. A while later it seemed to have closed up a bit again, I used the estrogen cream for a week and it opened right up. Now she's 13 months and it's been staying open no problem.
Long story short: Adhesions are common and they're no big deal. From our experience, estrogen cream and manually opening the adhesion are both safe and pain free. I think it might actually be more painful to have to pee with an adhesion.
Posted by: Danielle | October 25, 2007 at 12:35 AM
My 17-mo-old daughter has had an on-again, off-again adhesion since 9 months. We opted out of the estrogen cream and instead just apply a little pressure with a vaseline covered finger at diaper changes. This is typically successful in keeping things open, although my peanut doesn't always love being messed with. When we are lazy or forgetful about doing so, things begin to re-adhere. We aren't freaking about it yet, for many of the same reasons noted by Danielle and Rasa.
Rasa, do you mind sharing the name of your doc, just in case this continues?
Posted by: Colleen | October 25, 2007 at 12:54 PM
My daughter also was diagnosed with labia adhesion around her first birthday and we were prescribed the hormone cream. The doctor gave no indication that it was serious and I barely applied it. About 6 months later, she had closed up more to the point it was about the diameter of a pencil. Then we got concerned about urinary infections (I know I hate having them!) and began to apply the cream as prescribed. Within a month or so it had completely opened back up and a year later, has stayed open. I really don't recommend just leaving it especially if it is closing up more - I would feel guilty if I was increasing my daughter's chance of getting uncomfortable and painful infections.
I do have a friend who has reduced her son's intake of soy products b/c she feels the increased estrogen is possibly increasing his emotional outbursts...? Maybe soy products could help with labia adhesion??
Posted by: laura | October 26, 2007 at 12:20 PM
The pediatric urologist we saw was Dr. R. Guy Hudson
http://www.ohsu.edu/health/meet-our-staff/doctors/doctor.cfm?id=11381
Fortunately in our case, our daughter's adhesion is only blocking the opening to the vagina, and is not blocking any part of her urethra (so no reason for urinary tract infections), which probably contributed to the Dr.'s comfort with a "wait and see" approach. But he was willing to open the adhesion if that is what we wanted. He was very good with our daughter (she was about 18 months or so at the time of the visit) and with us too.
Posted by: Rasa | October 28, 2007 at 10:54 PM
Hi ladies, I am going through this with my 1 yrnold dd. How did things turnout with your little ones?
Posted by: Rose | December 22, 2012 at 11:04 PM