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Treatment with oestrogen or manual separation for labial adhesions - initial outcome and long-term follow-up

Wejde, Ellen; Ekmark, Ann Nozohoor LU and Stenström, Pernilla LU (2018) In BMC Pediatrics 18(1).
Abstract

Background: Topical oestrogen and manual separation are the main treatments for labial adhesions. The aim was to evaluate treatment of labial adhesions and compare the outcome of topical oestrogen treatment with that of manual separation. Method: All girls aged 0-12 years admitted to a tertiary centre for paediatric surgery for labial adhesions were included. The study design was dual: The first part was a retrospective chart review of the treatment success according to the medical charts. The second part was a cross-sectional parent-reported long-term outcome study (> 6 months after last treatment finished). Results: In total 71 patients were included and the median follow-up time for the chart study was 84 (6-162) months after... (More)

Background: Topical oestrogen and manual separation are the main treatments for labial adhesions. The aim was to evaluate treatment of labial adhesions and compare the outcome of topical oestrogen treatment with that of manual separation. Method: All girls aged 0-12 years admitted to a tertiary centre for paediatric surgery for labial adhesions were included. The study design was dual: The first part was a retrospective chart review of the treatment success according to the medical charts. The second part was a cross-sectional parent-reported long-term outcome study (> 6 months after last treatment finished). Results: In total 71 patients were included and the median follow-up time for the chart study was 84 (6-162) months after treatment with oestrogen or manual separation. Oestrogen was the first treatment for 66 patients who had an initial successful rate of 62% but this was followed by recurrences in 44%. Five patients had manual treatment as their first treatment and they had a 100% initial success rate followed by recurrences in 20%. Therefore, for the first treatment course there was a final success rate of 35% for oestrogen and 80% for manual separation (p = 0.006). Corresponding final success rates including all consecutive treatments over the study period were 46/130 (35%) for oestrogen and 21/30 (70%) for manual separation (p = 0.001). The success rate for oestrogen did not differ if treatment was given in a course length of 0-4 weeks (39% success) or > 4 weeks (32% success) (p = 0.369). In the parent-reported long-term outcome study the response rate was 51% (36/71). Parents reported that recurrences of adhesions after last prescribed/performed treatment were frequent: in total 25% of patients still had adhesions corresponding to 8/29 (29%) of those whose last treatment was oestrogen and 1/9 (11%) of those whose last treatment was manual separation. Conclusion: Due to the results recurrences are common after both oestrogen and manual separations. However, the overall final outcome after manual separation seems to be more successful when compared to that of topical oestrogen treatment.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Labial adhesions, Long-term outcome, Manual separation, Oestrogen, Treatment
in
BMC Pediatrics
volume
18
issue
1
pages
9 pages
publisher
BioMed Central
external identifiers
  • scopus:85043457448
ISSN
1471-2431
DOI
10.1186/s12887-018-1018-x
language
English
LU publication?
yes
id
3ec62ea5-f4d7-4935-a1ec-b41b596c1567
date added to LUP
2018-04-03 11:24:29
date last changed
2019-01-06 13:49:29
@article{3ec62ea5-f4d7-4935-a1ec-b41b596c1567,
  abstract     = {<p>Background: Topical oestrogen and manual separation are the main treatments for labial adhesions. The aim was to evaluate treatment of labial adhesions and compare the outcome of topical oestrogen treatment with that of manual separation. Method: All girls aged 0-12 years admitted to a tertiary centre for paediatric surgery for labial adhesions were included. The study design was dual: The first part was a retrospective chart review of the treatment success according to the medical charts. The second part was a cross-sectional parent-reported long-term outcome study (&gt; 6 months after last treatment finished). Results: In total 71 patients were included and the median follow-up time for the chart study was 84 (6-162) months after treatment with oestrogen or manual separation. Oestrogen was the first treatment for 66 patients who had an initial successful rate of 62% but this was followed by recurrences in 44%. Five patients had manual treatment as their first treatment and they had a 100% initial success rate followed by recurrences in 20%. Therefore, for the first treatment course there was a final success rate of 35% for oestrogen and 80% for manual separation (p = 0.006). Corresponding final success rates including all consecutive treatments over the study period were 46/130 (35%) for oestrogen and 21/30 (70%) for manual separation (p = 0.001). The success rate for oestrogen did not differ if treatment was given in a course length of 0-4 weeks (39% success) or &gt; 4 weeks (32% success) (p = 0.369). In the parent-reported long-term outcome study the response rate was 51% (36/71). Parents reported that recurrences of adhesions after last prescribed/performed treatment were frequent: in total 25% of patients still had adhesions corresponding to 8/29 (29%) of those whose last treatment was oestrogen and 1/9 (11%) of those whose last treatment was manual separation. Conclusion: Due to the results recurrences are common after both oestrogen and manual separations. However, the overall final outcome after manual separation seems to be more successful when compared to that of topical oestrogen treatment.</p>},
  articleno    = {104},
  author       = {Wejde, Ellen and Ekmark, Ann Nozohoor and Stenström, Pernilla},
  issn         = {1471-2431},
  keyword      = {Labial adhesions,Long-term outcome,Manual separation,Oestrogen,Treatment},
  language     = {eng},
  month        = {03},
  number       = {1},
  pages        = {9},
  publisher    = {BioMed Central},
  series       = {BMC Pediatrics},
  title        = {Treatment with oestrogen or manual separation for labial adhesions - initial outcome and long-term follow-up},
  url          = {http://dx.doi.org/10.1186/s12887-018-1018-x},
  volume       = {18},
  year         = {2018},
}