+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Comparison of Conservative and Surgical Therapy Concepts for Synechia of the Labia in Pre-Pubertal Girls

, : Comparison of Conservative and Surgical Therapy Concepts for Synechia of the Labia in Pre-Pubertal Girls. Geburtshilfe und Frauenheilkunde 76(4): 390-395

NlmCategory="UNASSIGNED">Introduction: The aim of this study was to evaluate the primary and secondary therapeutic successes of different therapy schemes for the treatment of synechia of the labia in pre-pubertal girls. Materials and Methods: The treatment courses of 47 pre-pubertal girls who were treated between February 2007 and February 2013 in the special outpatient clinic for paediatric gynaecology of a department for gynaecology at a German university hospital and for whom information on the course of the disease was available for at least the six months following end of the treatment. 23 of these children were treated with a topical estriol therapy (treatment group A). For 24 of the girls a manual separation of the adhering labia minora was undertaken (treatment group B). Statistical evaluation was performed using the χ2 test, Fischer's exact test and the Mann-Whitney U test. Results: For 18 of the 23 (80 %) girls in treatment group A topical estriol therapy alone led to a resolution of the synechia. Five of these 23 children (20 %) required a secondary manual separation. All girls for whom treatment was not successful were under 5 years of age. For all 24 girls (100 %) of treatment group B the primary manual separation was performed with success. The recurrence rates after ≥ 6 months in cases with identical after-care did not differ between the two treatment groups (treatment group A: 34 %, treatment group B: 33 %, χ2 test: p = 0.853). 16 of the 17 recurrences occurred ≥ 3 months after the end of the therapy. Conclusion: Our results show that for children < 5 years of age a 4-week topical therapy with estriol is a promising therapy option for synechia of the labia that is less of a burden for the family situation. Especially for girls ≥ 5 years of age, primary therapy fails in up to 20 % of the cases. Primary manual separation represents a more effective therapeutic option. Irrespective of the treatment applied, a recurrence after ≥ 3 must be expected in one-third of the treated girls.Label="ZUSAMMENFASSUNG">Fragestellung: Ziel dieser Untersuchung war es, den primären und sekundären Therapieerfolg unterschiedlicher Therapieschemata zur Behandlung einer Labiensynechie präpubertaler Mädchen zu evaluieren. Material und Methodik: Retrospektiv wurden die Behandlungsverläufe von 47 präpubertalen Mädchen analysiert, die zwischen Februar 2007 und Februar 2013 wegen einer Labiensynechie in der kindergynäkologischen Spezialsprechstunde einer Universitätsfrauenklinik behandelt wurden und bei denen Informationen über den weiteren Krankheitsverlauf über einen Zeitraum von mindestens 6 Monaten nach Therapieende verfügbar waren. 23 dieser Kinder wurden mit einer topischen Estrioltherapie behandelt (Behandlungsgruppe A). Bei 24 Kindern wurde eine manuelle Separation der adhärenten Labia minora durchgeführt (Behandlungsgruppe B). Die statistische Auswertung erfolgte mithilfe des χ2-Tests, des exakten Tests nach Fisher und des U-Tests nach Mann-Whitney. Ergebnisse: Bei 18 der 23 (80 %) der Mädchen der Behandlungsgruppe A führte die alleinige topische Estrioltherapie zu einer Lösung der Synechie. Fünf dieser 23 Kinder (20 %) mussten sekundär mit einer manuellen Separation behandelt werden. Alle Mädchen mit ausbleibendem Therapieerfolg waren ≥ 5 Jahre. Bei allen 24 Mädchen (100 %) der Behandlungsgruppe B konnte die primäre manuelle Separation erfolgreich durchgeführt werden. Die Rezidivrate nach ≥ 6 Monaten unterschied sich zwischen den beiden Behandlungsgruppen bei identischer Nachbehandlung nicht (Behandlungsgruppe A: 34 %, Behandlungsgruppe B: 33 %, χ2-test: p = 0,853). 16 der 17 Rezidive traten ≥ 3 Monate nach Therapieende auf. Schlussfolgerung: Unsere Ergebnisse zeigen, dass bei Kindern < 5 Jahren eine 4-wöchige topische Therapie mit Estriol eine erfolgversprechende, die familiäre Situation wenig belastende Therapieoption zur Behandlung der Labiensynechie darstellt. Besonders bei älteren Mädchen ≥ 5 Jahren kommt es in bis zu 20 % zu einem primären Therapieversagen. Die primäre manuelle Separation stellt eine wirkungsvollere Therapieoption dar. Unabhängig von der durchgeführten Behandlung muss mit einem Rezidiv nach ≥ 3 Monaten in einem Drittel der behandelten Mädchen gerechnet werden.


PMID: 27134294

DOI: 10.1055/s-0035-1558101

Other references

Vrethem; Davidsson; Bak, 1999: Intracerebral malignant lymphoma in a patient with long-standing multiple sclerosis. We present a patient with long-standing MS who developed a malignant intracerebral lymphoma, suspected on MRI and verified by brain biopsy. This raises the interesting question about whether the coexistence of the two conditions is explained by ca...

Allamaneni, S.S.R.; Agarwal, A.; Nallella, K.P.; Sharma, R.K.; Thomas, A.J.; Sikka, S.C., 2005: Characterization of oxidative stress status by evaluation of reactive oxygen species levels in whole semen and isolated spermatozoa. We defined the basal levels of reactive oxygen species (ROS) in normal donors in neat (whole unprocessed) semen specimens, and in mature and immature spermatozoa isolated by a double-density gradient technique. In addition, we demonstrated that th...

Whiteman H.; Wissinger S.A.; Horn S., 1990: Ecological correlates of pedomorphosis in high elevation populations of the tiger salamander ambystoma tigrinum nebulosum. American Zoologist 30(4): 86A

Zhou, X.; Li, B-fu., 2008: Comparison between the head-chest leads electrocardiogram and routine leads in the manifest accessory pathways in patients with Wolff-Parkinson-White syndrome. To observe whether there was difference between the head-chest leads electrocardiogram (HCECGs) and routine lead electrocardiogram (RLECGs) in the manifest accessory pathways in patients with Wolff-Parkinson-White syndrome. HCECGs and RLECGs were...

Penka, M.; Parizek, M.; Cronberg, S.; Kubisz, P., 1992: Protein C and hypertension. Protein C antigen and amidolytic activity were assayed in 38 patients with essential hypertension at the first stage of disease. As compared to 20 normal healthy blood donors no abnormality was found.

Lacey, S.F.; Larder, B.A., 1994: Mutagenic study of codons 74 and 215 of the human immunodeficiency virus type 1 reverse transcriptase, which are significant in nucleoside analog resistance. Mutation in the human immunodeficiency virus type 1. reverse transcriptase (RT) at codon 215 has been shown to play a significant role in resistance to zidovudine (AZT). Substitution of threonine with tyrosine or phenylalanine alone confers decrea...

Barnes, H.J., 1905: The Work of the Health Education League of Boston. Public Health Papers and Reports 31(Pt 1): 150-151

Anonymous, 2016: Correction in author list. [This corrects the article on p. e731 in vol. 9, PMID: 26664509.].

Fan, Y.Liang.; Hou, H.Wei.; Tay, H.Min.; Guo, W.Mei.; Berggren, P-Olof.; Loo, S.Chye.Joachim., 2017: Preservation of Anticancer and Immunosuppressive Properties of Rapamycin Achieved Through Controlled Releasing Particles. Rapamycin is commonly used in chemotherapy and posttransplantation rejection suppression, where sustained release is preferred. Conventionally, rapamycin has to be administered in excess due to its poor solubility, and this often leads to cytotoxi...

Jiang PengYan, 1996: Methods of application of nitrogen fertilizer to rice. Various aspects of application of N to rice are discussed including the development of the methods used at present, the most important methods employed and the amounts of applied fertilizer used by the crop. The relationship between soil N and the...