Synechia of the labia in girls: how to recognize and how to treat. Inflammatory process of the external genitalia - vulvitis in girls: causes of development, methods of treatment and prevention of infection The structure of the genital organs in a child

Synechiae in girls is very common. It is important to detect the disease in time to prevent complications.

Most parents are not even aware of synechiae of the labia minora in girls. They don’t talk about this in courses for expectant mothers. It is difficult for a mother, even a woman, to determine whether her daughter has synechiae or not.

What do synechiae of the vagina and labia minora look like in girls?

Synechia, simply put, is a fusion. Synechia of the labia minora is the fusion of the labia minora in a girl. Possible fusion of the labia minora with the labia majora. Fusion can be complete or partial.

To examine your daughter for the presence of synechia, you need to:

wash your hands well with soap
nails should be cut short
put the baby on her back
Gently spread your legs and carefully examine the genitals

Having opened the labia majora, the mother will see that the labia minora are tightly pressed to each other and a film has formed between them. The vagina is not visible at all, or only part of it can be seen. When I try to separate the jaws, nothing happens. This brings pain to the baby and the child begins to cry.

IMPORTANT: With a normal structure of the labia minora, the gap is large, the vagina is clearly visible. The labia minora look like petals and are separate from the labia majora.

Signs of synechia in girls

IMPORTANT: The main sign of the presence of synechia in a girl will be problems with urination. The child will cry and strain. Relief comes only after urination. The situation worsens in the evenings. The baby practically cannot sleep.

Sign indicating the possible appearance of synechia are:

redness of the baby's genitals, the presence of a small rash
When washing, there may be painful sensations, the girl will cry
Synechia is also indicated by the fact that when urinating, urine rises in a stream upward, like in boys
constant leakage of urine, the child went to the potty, but his panties were always wet

Synechia in girls, photo

The first photo shows the normal structure of the genital organs. The second photo clearly shows the complete fusion of the labia minora.

Synechia in infant girls

Almost from the first days of life, girls can have fused labia. It is believed that The cause of this disease is low levels of sex hormones. This should not alarm parents. Since the absence of sex hormones before puberty is the norm.

Up to about 8 years of age, relapses of the disease are possible. As a girl grows up, the genital mucosa becomes less susceptible to external irritants and more dense. And it hardly grows together.

Causes of synechia in girls

The reasons that can provoke synechiae are:

food allergies in a child to certain foods in the diet of a baby or mother who is breastfeeding
household allergies can occur to diapers, powder, cream, soap, napkins, oil
insufficient washing
washing too often
use when washing soap
improper washing
genitourinary system infections
hormonal medications taken by the mother while the baby is pregnant
dysbacteriosis
worms

In order to find the cause of the formation of synechiae, the specialist will prescribe a series of tests:

vaginal smears
blood and urine test
feces for dysbacteriosis and worm eggs
scraping for enterobiasis

Breeding synechiae in girls

IMPORTANT: The earlier synechiae are detected, the easier it is to breed them. At the very beginning of the disease, the film is thin and transparent. And when fully fused, it becomes dense, the body perceives the genital gap as a wound, and without surgical intervention it cannot be separated.

You cannot do this on your own; you can only harm the child. If you suspect synechia, you should seek help from a pediatric gynecologist.
It is believed that synechiae should not be touched at the initial stage, but should be diluted only when the fusion brings discomfort to the baby

Treatment of synechiae, dissection of synechiae in girls

The dissection of synechiae in girls is done by a pediatric gynecologist. This procedure is performed using a scalpel and takes a few seconds. The manipulation is painful and requires special care for the baby’s genitals
To relieve painful urination and wound healing, sitz baths, lotions and antibacterial ointments are recommended

IMPORTANT: Dissection does not protect against repeated relapses. The labia minora may grow back together. Parents have the right to refuse this method of treatment, but with complete fusion, when urination is impaired, this is the only way to help the girl.

give up diapers
carefully monitor your baby’s personal hygiene
lubricate the labia with baby cream and vegetable oil
do air baths as often as possible.

How to treat synechiae in girls at home?

Treatment of synechiae at home is possible only with partial and uncomplicated fusion. To do this, use warm sitz baths with the addition of medicinal herbs such as chamomile, calendula, string.

The procedure takes 10 minutes. After this, it is recommended to lubricate the fusion site with sea buckthorn, olive or peach oil. The oil must be clean, without impurities.

IMPORTANT: before use, you must check if your child is allergic to the selected type of oil.

Cream for synechia in girls

If synechiae progresses and causes discomfort to the baby, a specialist will prescribe special hormonal creams
They can be used only in strictly specified quantities and once a day. Apply such creams with a clean index finger, strictly to the area of adhesion. The course of treatment is 14 days
After a course of treatment with hormonal cream, the area of the labia minora is treated with baby cream without fragrances. Apply cream after washing

Ointment for synechia in girls

To improve the effect of using hormonal cream, ointments are prescribed. They are applied to the adhesion zone in the morning, after washing. These ointments include Traumeel S, cream-gel Malavit, Contractubex.

Does Contractubex help with synechiae in girls?

Contractubex is an anti-scar gel. Used as an additional remedy in the treatment of synechiae in girls
Apply a thin layer to the adhesion site twice a day. If the doctor or parents do not want to use hormonal creams, treatment is only possible contractubex
This method requires more time and patience. The full course of treatment is 3 months . When used correctly it gives results

Ovestin treatment of synechia in a girl

For successful treatment of synechiae, a hormonal cream is prescribed.

IMPORTANT: Ovestin, when used correctly, acts only on synechiae and does not affect the baby’s hormonal levels.

Use Ovestin once a day after evening washing.

Apply half a centimeter of cream to your finger
gently spread the labia majora
apply cream to the adhesion line
make light circular movements with the labia majora
You cannot put on a diaper immediately after the procedure; you must wait until the cream is absorbed
When applied Ovestin It is recommended to use only your finger. But, some doctors advise using a cotton swab and rubbing the cream into the commissure. This must be done carefully so as not to damage the girl’s genitals.
The course of treatment is 14 days . If the synechiae have not resolved or have resolved, but only partially, after a ten-day break you can continue treatment

Prevention of synechiae in girls

In order to prevent synechiae in girls, you need to:

wash properly, this is done every day under running water and from front to back to avoid infection
wash only with your hands, it is strictly forbidden to use a washcloth, as this can damage the delicate tissue of the labia
When washing, use soap only once a week; it should be baby soap without fragrances or dyes. Frequent use of soap dries out the mucous membrane and provokes synechiae. It's better to give up soap altogether
use diapers correctly, change them every three hours or more often
do air baths for the genitals, the longer the better
choose underwear only from natural fabrics and in size; before putting it on the child, it must be ironed
wash children's clothes separately from adults' clothes
If your child is allergic, closely monitor allergic reactions. In case of redness, generously lubricate the labia minora with unscented baby cream or use diaper rash cream
do not overuse herbal or potassium permanganate baths

IMPORTANT: It is imperative to examine the baby’s genitals. The earlier synechiae are diagnosed, the easier it is to treat them.

Most mothers and specialists speak positively about treatment with hormonal cream. When applied correctly, synechiae pass easily and painlessly
After dilating the labia minora, the adhesion site should be treated with additional non-hormonal ointments
The use of Ovestin is also justified in case of fusion of the labia minora with the labia majora. The cream is applied to the fusion site and the result will be visible in about a week

In the fight against synechiae:

Be sure to exclude allergens, both household and food. Otherwise, the mucous membrane will be irritated and re-growth may occur.
In case of viral infections, carefully monitor the labia minora
Lubricate with baby cream or oil several times a day. Massage the perineum
If the fusion of the labia is partial and does not cause discomfort, carry out only observational tactics

Many mothers are worried about frequent relapses of synechiae. This means something was done wrong. We need to be patient. And, most importantly, remember that the girl will grow up, and the problem will go away on its own.

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

Video: Why synechiae occurs in girls - Dr. Komarovsky

Video: When to treat synechiae in girls - Dr. Komarovsky

Video: How to treat fusion of the labia - Dr. Komarovsky

How does the reproductive system of children work and how to keep it healthy? All young parents should know the answers to these questions in order to eventually become happy grandparents.

What the “intimate” health of boys and girls will be like is decided over 2 periods - short, but very important. These are the first 4 months from the moment of conception, which account for the formation of sex, and the period of puberty in adolescence. Let's see what happens during the first stage.

Where does it all begin?

Who will be born into a family, a son or a daughter, is decided during fertilization - everything is determined by chromosomes. Already in the first days after conception, the rudiments of the gonads appear in the unborn baby, and for now the fetus. The gonad consists of a medulla and cortex and carries future male and female cells. It is interesting that at first they are the same for both girls and boys, but they will turn into special ones that distinguish each sex within 7 weeks. It is important that during this time the transformation goes well.

ATTENTION! In the first 8 weeks of pregnancy, a lot depends on the mother: she needs to try to avoid infections, taking medications, alcohol, smoking, otherwise all this can affect the formation of the child’s organs.

If the fertilized egg contains the Y chromosome, which is responsible for the male sex, between the 6th and 7th weeks of pregnancy a testicle is formed from the medulla of the gonad, and the cortical layer gradually “disappears.” If the influence of the Y chromosome has not manifested itself before this time, the gonad turns into an ovary - this time at the expense of the cortex, and the medulla remains unclaimed. It turns out that the genital organs of girls and boys are formed from the same “material”: for example, from the ducts of the primary kidney (mesonephros) in boys the seminal vesicles and vas deferens are formed, and in girls from the paramesonephric duct adjacent to this kidney - the uterus and partially vagina.

Guided by hormones

Before birth, the formation of the reproductive organs of future boys is actively controlled by hormones, while in girls it occurs on its own - even congenital anomalies of the ovaries do not affect this process. The transformation into a boy is controlled by hormones produced by the formed testicle: for example, under the influence of testosterone, a small tubercle turns into a penis, the scrotum and urethra are formed.

By the time a little person is born, the genitals are already formed. The child grows and develops, but no serious changes occur in his “personal” sphere until the age of 10-12, when the sex glands gradually become active and hormonal changes begin. Until this moment, a “childhood support center” operates in the body: two organs, the posterior hypothalamus and the pineal gland, for the time being inhibit the production of male and female hormones, preventing the child from growing up ahead of time. Thanks to their work until adolescence, there are no particular differences in physique between boys and girls.

Construction defects

The first thing that allows us to judge problems is disturbances in the external structure of the genital organs. Since they are laid before birth, the most serious of them are identified already in the maternity hospital. What situations do doctors encounter most often?

Boys

Hypospadias

With this problem, the external opening of the urethra is located incorrectly, for example, not in the center of the head of the penis, but on the side. If this defect leads to difficulties (for example, with a “small toilet”), the child undergoes surgery.

Cryptorchidism

This is the name for the situation when one or (less often) both testicles do not have time to descend into the scrotum by the time of birth. This is a natural condition for all boys born prematurely, and in full-term children this happens in approximately 1 case in 150-200, if one testicle is “late,” and in 1 case in 600, if we are talking about both. Most often, these organs themselves take their rightful place in the first 3 months of life. At this time, doctors are monitoring the child, and if it becomes clear that the situation will not change without surgery, it will be performed without delay.

Varicocele

These are varicose veins of the testicle and spermatic cord (it connects the testicle to the surrounding muscles). Varicocele develops when the walls of the vessels are too weak: because of it, the vein responsible for the outflow of blood from the testicle is compressed by other vessels and tissues. The blood stagnates, less oxygen reaches the tissues, and this impairs the functioning of the testicle and spermatic cord. And since the vas deferens is located inside the cord, the expansion of the veins in the future will interfere with the movement of sperm. So varicocele, if left untreated, affects the ability to have children - it is no coincidence that this is the most common cause of male infertility in our time. Most often, the disease does not manifest itself in any way, and it can be discovered by chance (during an examination or an ultrasound scan for other problems), and for treatment the baby will definitely need the help of a surgeon.

ATTENTION! If disturbances in the structure of the genital organs require surgery, it is better not to delay it: although many of these problems do not bother the child until adolescence and even adulthood, in the future they can threaten serious complications, such as infertility.

Disturbances in the structure of the genital organs are more common in boys than in girls.

Girls

The intimate organs of newborn babies are very tiny, and doctors in the maternity hospital examine them especially carefully. But sometimes mothers are the first to notice “something strange” at home.

Disturbances in the structure of the external genitalia

They can literally lie on the surface (for example, an enlarged or poorly developed clitoris, fusion of the labia), and those that are hidden in the depths (such as a closed or absent hymen) are discovered only during an examination. The only way to eliminate them is surgery. And if there are serious hormonal imbalances, the girl will need medication treatment.

Disorders of the internal genital organs

Sometimes changes affect the uterus and ovaries (for example, they may be absent - then doctors talk about agenesis, or aplasia, of these organs), and such disorders can only be identified with the help of ultrasound, x-rays or endoscopic techniques.

Looking for a reason

Why do babies have problems in the structure of their genital organs? As we have found out, most often the conditions for this appear before birth. Let's list the most common ones.

Disturbances in the recruitment or functioning of sex chromosomes

They are often inherited. For example, if a girl, instead of 2 sex chromosomes (XX), has only 1 (Shereshevsky-Turner syndrome), the baby will be delayed in growth and development, including the genitals.

Changes in the sensitivity of fetal tissue to sex hormones

Because of this, the development of “intimate” organs may occur too quickly or, conversely, too slowly. These troubles can be hereditary, and sometimes arise due to the mother’s problems while expecting the baby.

Early pregnancy illnesses

The reproductive system of children is especially affected by the endocrine problems of mothers and the hormonal treatment that they receive, not yet knowing about the “position”.

Components of health

In order for little boys and girls to turn into healthy men and women, several conditions must coincide. We have already discovered two of them: the correct set of chromosomes and the normal development of the hormonal system and genital organs. The third point is the general health of the body. Here are a few more points that pediatricians remind parents of.

Proper care

Although caring for newborn girls and boys is not much different, there are some nuances for young ladies. Babies need to be washed strictly from front to back so as not to introduce infection into the vagina, but for boys the direction is not important. Girls need to wash the folds in the groin and perineum especially carefully - feces particles can cause inflammation of the genital organs.

ATTENTION! In the first days after the birth of a baby, a sexual crisis occurs in his body - hormonal changes in response to the release of the mother's estrogens. On the 4th-6th day, the mammary glands enlarge, and a liquid similar to milk may be released from the nipples - this happens in boys and girls. These phenomena intensify by the 8-10th day of life, and disappear after 2-3 weeks. On the 4-8th day, girls may experience gray-white vaginal discharge, and in 10% of babies it may be bloody. In boys, swelling of the scrotum may occur at the same time. All these conditions go away on their own, and there is no need to interfere. Do not squeeze milk out of the mammary glands, smear them with ointment, or treat the genitals with anything. Be sure to consult a doctor!

Doctor visits

Routine examinations of children by pediatricians will help not to miss, among other things, problems of the genital area. In boys, it is easier to monitor the health of these organs than in girls, because for them there are standards for the size of the testicles and penis, depending on age. It is more difficult to detect the “intimate” problems of girls, especially since they do not undergo routine examinations by gynecologists. So the mother will have to monitor whether everything is okay with her daughter.

What should you pay attention to?

The reasons for contacting a doctor should be the following situations:

The boy developed pain and swelling in the area of the penis and scrotum, and the girl experienced pain and swelling in the area of the labia minora, labia majora or clitoris;

- swollen mammary glands (for both sexes);

- the baby’s scrotum has greatly enlarged, his voice has become rougher;

- hair began to grow on the face and body of the boy and girl;

- the child is too attentive to his genitals, examines and plays with them for a long time (from 2 years).

Based on materials from the magazine "Happy Parents"
Konstantin Grigoriev, pediatrician, professor

Mavrov I.I.

The genital apparatus of a child differs significantly in size and structure from the genital organs of an adult. In the first 6 years of life, the growth of the genital organs is insignificant and does not correspond to the growth of the whole organism. Subsequently, it intensifies somewhat, and at the age of 14-15 years, a teenager experiences significant changes in the development of the genital organs.

Anatomy of the genital organs in boys.

By the time of birth, the baby's penis is fully formed. In a newborn it has an average length of 2-2.5 cm, in a 4-year-old boy - 2.5-3 cm, in a 7-year-old boy - 4.5 cm, and by the age of 16-18 it reaches the size characteristic of adults .

The foreskin of newborns is usually longer than that of infants, protrudes strongly, and is quite narrow, which causes the presence of physiological phimosis. On the inner surface of the foreskin, and especially on the head, there are numerous glands that form smegma.

In newborns, the foreskin of the penis, due to gluing of the inner layer of the foreskin and the outer surface of the glans, sticks to the head (their epithelial cells do not undergo the process of keratinization). Until the age of 3, this adhesion is usually observed up to the opening of the urethra, then, under the influence of erections and manual manipulation, the size of the adhesion decreases, and by the 5th year of life, the head is only half closed, and by the 8-10th year the entire head is exposed.

The length of the urethra in newborn boys is 5-6 cm. With age, it increases annually by an average of 0.5 cm, and by the age of 16 it reaches 16-18 cm.

The mucous membrane of the children's urethra is smooth, without folds. The glands of the urethra have a very small diameter of the excretory ducts, which is vitally important because it makes it difficult for pathogenic microorganisms to penetrate the corresponding organs, thereby preventing the development of complications. Therefore, urethritis, which sometimes occurs in infants, has a short course and is usually not accompanied by complications (epididymitis, orchitis, etc.). However, the urethral mucosa of infants is very thin throughout its entire length and is easily torn.

The scrotum in a newborn is a small sac (4.5x3.5 cm) with flaccid walls. By the first year of life, it becomes more rounded, and its walls become more tense. The scrotum retains its rounded shape during the first decade, and by the age of 15 it is distinguished by a wide bottom with the testicles and a narrower part - the neck.

Shortly before birth, the testicle descends into the scrotum, carrying the vas deferens with it, and takes its final position. In a newborn, the testicles are relatively small, then their growth slows down, and during the first 10 years they increase little in size and weight. A slight increase is observed between 10 and 14 years; by 16-18 years, the testicles reach their maximum development, acquiring the properties of a mature sex gland.

The testicular parenchyma of a newborn is relatively rich in connective tissue. Its seminiferous tubules are cords due to their lack of lumens. The latter are formed only with the beginning of spermatogenesis.

The epididymis of a newborn is more pronounced than in adults. Its mass is more than half the mass of the testicle. Just like the testicle, the epididymis grows slightly in the first 10 years of life and only during puberty it quickly increases in size.

The spermatic cord in newborns and infants has a diameter of 14 mm, at the age of 15 years - 18 mm, and in adults - 20-25 mm. The vas deferens is basically similar to that of an adult. As a result of the growth of the organism, its length doubles. The seminal vesicle in a newborn is located higher than in an adult man, but does not differ in shape. It grows slowly, its significant increase occurs only during puberty.

The prostate gland in a newborn consists predominantly of smooth muscle and connective tissue; It has a spherical shape, is not divided into lobes, and does not have an isthmus. It takes on the chestnut form only at the age of 13-14 years. The weight of the gland is on average 0.82 g; up to 2 years it increases slightly, growing noticeably between the ages of 6 and 16 years. Inside the gland there are blind epithelial tubes; by the age of 12, the ducts of the gland begin to branch, and their secretion intensifies; by the age of 16-17 years, the excretory ducts of the tubular-alveolar prostatic glands open.

Anatomy and physiology of the genital organs in girls.

One of the distinctive anatomical features of the genital organs in little girls is the presence of a posterior commissure of the labia minora, which is not present in adult women. There are numerous glands on the labia minora and majora. However, they are often absent on the inner surface of the labia minora.

The vestibule of the vagina is lined with stratified squamous epithelial cells. The small glands of the vestibule are located mainly at the external opening of the urethra. Newborn girls have significantly more of them than adult women. The large glands of the vestibule (Bartholin's glands) begin to function during puberty; by the age of 10-12 years their excretory ducts have a typical structure - covered with columnar epithelium.

The length of the urethra in newborn girls is 1-1.5 cm, at the age of 1 month. - 1.6 cm, 12 months. - 2.2 cm, 16 years - 3.2 cm. The external opening of the urethra opens into the vestibule 1-1.5 cm below the clitoris between the labia minora; has an oval or slot-like shape. The mucous membrane of the urethra in girls is rich in folds. The glands of Littre and the lacunae of Morgagni are located along the entire length of the urethra, but there are more of them in the anterior part of the canal. Some of them open into the vestibule of the vagina.

The ovaries in childhood grow slowly, and their weight increases gradually: by the end of the 1st year of life it doubles, by the age of 6 it increases 7 times, and by the age of 16 it increases 20 times compared to the weight at birth and reaches 5-6 g. The ovaries in newborns have an elongated and flattened shape, their surface is smooth, weight from 0.2 to 0.4 g. At the 2nd year of life they begin to become ovoid and are fully formed by 10 years.

The number of primary follicles decreases with age: in a 17-day-old child there are about 23 rows, in a 10-year-old girl - 6-8. During puberty, follicles in the cortex are at different stages of development. The oviducts do not lengthen in childhood. The convolutions of the oviducts decrease in the 5th year of life, when the transverse size of the pelvis increases. The ovarian ligaments stretch, and they, separating from the uterus, take their normal position.

By the time a girl is born, her uterus is about 4 cm long, her body is half as long as her cervix. After birth, involution occurs and its size decreases due to the cessation of the action of the placental secretion, which stimulates the growth of the uterus. In infancy, the length of the uterus is. 2.5-2.8 cm. Increased growth of the uterus begins after the age of 7-8 years. With the onset of puberty, it takes on the shape and size of an adult woman's uterus.

At the time of birth, the girl has uterine glands. Their number is individual and varies significantly regardless of the girl’s age. At the age of 6 years, a small number of glands are located mainly on the fundus of the uterus. By the age of 10, their number increases, and after 12 years, they evenly penetrate the entire mucous membrane of the uterus.

In newborns, the length of the vagina reaches 3 cm, the entrance is located very deep, has an almost vertical direction, as if drawn in like a funnel. The walls of the vagina are in close contact, the muscles are poorly developed and have little elasticity. In one-year-old girls, the length of the vagina is 4 cm. From the age of 8, folding of the walls appears. The absolute size of the vagina increases rapidly after 10 years of life and reaches 7-8 cm in length by the time of puberty.

In a newborn girl, the functional and morphological state of the vagina is influenced by placental hormones. The mucous membrane is well developed, the epithelium contains glycogen, and the contents are acidic. As placental estrogens disappear from 1 year to 10-12 years, glycogen is not formed in the vagina, there are no Dederlein rods, the reaction of the contents becomes alkaline (pH 7-8), as a result of this there is no protective function of the vagina, the epithelial cover becomes thinner.

In girls aged 12-14 years, the ovaries begin to produce their own sex hormones. The vaginal mucosa thickens, glycogen is formed in it, the reaction becomes acidic, Dederlein's vaginal bacillus appear in the vaginal contents, the uterus enlarges - all this indicates that puberty is approaching.

Bibliography

To prepare this work, materials were used from the site http://www.medicus.ru/

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Diseases of the reproductive system organs occur not only in adult women, but also in girls. They may develop vulvitis, vaginitis, and anomalies of the genital organs. A pediatric gynecologist deals with sexual problems in girls.

Approximately 10% of girls under 2 years old experience synechia - fusion of the labia minora or majora. This developmental defect generally does not pose a serious danger. But if a film forms between the lips and the fusion is large enough, then this causes a lot of inconvenience to the child and can lead to unpleasant consequences in the future. Therefore, specialist supervision and treatment for synechia are mandatory.

Reasons for the development of pathology

Fusion of the labia is most often a congenital anomaly. This is caused by an insufficient amount of estrogen in a woman’s body during pregnancy. Other factors can lead to synechiae:

Frequent washing of the genitals. The girl's genitals must be kept clean. But this needs to be done in moderation. Intense and too frequent washing can cause lip fusion. Using regular soap to wash small children is harmful. It is very aggressive on the delicate lining of the vulva and can damage it. The alkaline composition of soap in contact with water can cause redness and irritation of the labia. Then the affected areas begin to heal, forming synechiae. Therefore, it is better to use special delicate products for care.
Tight clothing made from synthetic fabrics. This cause of the disease is more common in girls 3-8 years old who wear uncomfortable synthetic clothing. Friction of the tissue against the vulva occurs, which causes the development of a defect. Tight-fitting clothes provoke increased sweating and irritation of the labia. Rough fabric and sloppy seams can also cause friction against delicate skin.
Presence of genitourinary tract infections. The labia can grow together under the influence of inflammation. Pathogenic organisms can enter the urethra and genitals due to insufficient hygiene, using other people's towels and washcloths, swimming in dirty ponds, or public baths. The infection can occur in a latent form, and at first appears as slight redness. If not treated in a timely manner, synechiae may develop.
Allergic reactions. The disease can occur as a reaction to irritating factors (allergens). The vulvar mucosa is very sensitive to various irritants, from which the tissues become inflamed. Without proper treatment, the labia grow together.

Signs and symptoms

At the beginning of the adhesive process of the labia, the girl does not experience any particular discomfort. But With complete or partial fusion, symptoms appear that should not be ignored:

slow passage of urine and with straining;
restlessness or crying while urinating;
the direction of the urine stream is upward;
frequent irritation of the child’s genitals and thighs;
the genitals have an atypical structure.

What do synechiae look like in girls? The pathology has the appearance of a thin whitish-gray film that connects the labia at different lengths.

Why are synechiae dangerous in girls?

Synechiae whose size does not exceed 5 mm are considered harmless to health. They do not affect the flow of urine and do not cause pain in girls. There is no need to treat them. But you need regular observation by a gynecologist.

With significant gluing of the labia majora and minora, the vagina turns into a closed space. All vaginal discharge begins to accumulate in it. And this is a beneficial environment for the proliferation of pathogenic microflora. First, an inflammatory process occurs, which subsequently leads to an infectious disease.

Note! Synechiae tend to progress. The development of the organs of the reproductive system may not occur correctly. This is a dangerous disorder of reproductive function that leads to infertility.

Diagnostics

To identify synechiae, a simple examination is sufficient. If fusion of the labia is detected, the child should be shown to a doctor. to determine a follow-up plan. To find out whether the adhesive process has become a source of infection, it is necessary to undergo several tests:

strokes;
urine culture;
examination for urogenital infections;
Ultrasound of the pelvic organs.

General rules and methods of treatment

Sometimes treatment for synechia in girls is not carried out if their size is very small and they do not affect the physiological processes in the body. In this case, there must be constant monitoring by a doctor who will monitor possible inflammatory processes. If there are no signs of inflammation, it is enough for the child to provide proper hygiene care.

Conservative therapy

It is prescribed in the initial stages of the adhesive process, with minor synechiae. It consists of external application of drugs that contain estrogen (for example, Colpotrophil). Such agents loosen the tissue in the area of adhesions and separate them. The duration of such therapy should be several weeks (about 3-4).

The cream should be applied only to the synechiae; it does not need to be applied to nearby healthy tissues. During the first half of treatment, the product is applied 2 times a day. Subsequent use: 1 time per day, apply cream with estrogen, 2 applications are replaced with neutral baby cream. Then you need to completely switch to baby cream. During the treatment period, the child should be seen by a gynecologist at least once every 2 weeks.

Rules for applying the cream:

apply with a clean finger exactly along the adhesion line;
when treating adhesions there should be gentle pressure;
It is prohibited to forcibly try to separate the splice sites;
During treatment with the cream, avoid irritation of the clitoris.

Hormonal creams can be prescribed only if there are no contraindications. Most experts agree that such products can only be used by children after 1 year. If conservative treatment is successful, the girl should be under the supervision of a gynecologist for another year with visits once a month.

To relieve skin irritation, you can prepare baths using medicinal herbs:

chamomile;
sequences;
calendula;
sage.

It is useful to do such baths before applying hormonal cream.

Surgical intervention

This method is used in cases of long-term fusion and when conservative therapy is ineffective. During surgery, the synechiae are separated under local anesthesia. Lidocaine or special creams with an anesthetic effect are used as an anesthetic. In rare cases, with very strong adhesions, general anesthesia is given.

After surgery, a course of treatment with Colpotrophin is carried out in order to exclude repeated relapses. AND The main thing for recovery is following the rules of hygiene and visiting a gynecologist.

In order to prevent the development of a pathology such as synechiae, or their reappearance after surgery, you should especially closely monitor the girl’s hygiene and teach her the rules of self-care from an early age. Recommendations:

Wash the baby after each bowel movement and make sure the perineum remains dry.

You need to wash the perineum in the direction from the labia to the anus in water at 37 o C.
Wash the genitals with clean hands (not sponges or washcloths); nails should be cut.
Underwear should only be made of natural cotton and not dyed in bright colors.
Do not use wet wipes, creams, powders in the perineal area, except as prescribed by a doctor.
Replace soap with a special product for intimate hygiene.
There is no need to add flavorings or antiseptics to the water.
Do not consume allergenic foods.

Synechia is a pathology that occurs quite often. Therefore, parents should respond in a timely manner to various alarming symptoms that are associated with the genitourinary system. The disease is dangerous if it causes problems with urination or becomes a source of inflammation. And neglected synechiae can lead to problems in the reproductive sphere in the future.

According to statistics, 10 out of 100 girls aged from birth to two years are diagnosed with synechia of the labia. What it is? This is serious? How to treat? Can it be prevented? All our questions about synechiae in girls were answered by Tatiana ZHORNIK, doctor at the Zdravitsa Medical Center, obstetrician-gynecologist of the highest category, candidate of medical sciences.

Possible contraindications. Specialist consultation required!

What are synechiae?

Synechia is an adhesion that occurs due to the appearance of adhesions between internal organs or external parts of the body. Such fusions of the labia minora, and less commonly, of the labia minora and labia majora, can occur in young girls.

Expert commentary

Fusion of the labia minora may be complete or incomplete. The presence of synechiae in a girl on a small area of skin of the labia minora is not dangerous, does not cause virtually any unpleasant sensations and, subject to hygiene requirements, resolves itself. Synechia or fusion of the labia minora, expressed to one degree or another, is found in approximately 10% of girls aged from birth to 2 years.

Causes of synechiae

Among the natural factors that contribute to the formation of synechiae are the following:

low content of sex hormones estrogen (in itself is the norm for a child’s body);
infectious and bacterial diseases;
allergy.

External factors that can affect the formation of synechiae:

the occurrence of diaper rash due to untimely change of diapers;
rubbing underwear in the genital area;
constant wearing of synthetic underwear;
excessive hygiene.

Attention! Caring for the delicate skin of little girls requires special delicacy. Too frequent (many times a day) washing, even with the mildest baby soap, can lead to injury to the mucous membrane. Sponges and washcloths are not allowed!

This, of course, does not mean that you should forget about hygiene - insufficient washing can also serve as a provoking factor for the appearance of synechiae.

Expert commentary

First of all, a little anatomy. The labia minora are two thin folds that limit the entrance to the vagina, located from front to back and covered from the outside by the labia majora. The labia minora are not covered with mucous membrane, but with very thin, delicate and vulnerable skin. There is no adipose tissue in the thickness of the labia minora, but there are a lot of sebaceous glands. The peculiarity of the structure (delicate, thin skin) and location (warm, moist environment, closed state) of the labia minora creates the prerequisites for the development of various inflammatory processes, which are often complicated by the development of synechiae (adhesions). Additional factors that increase the risk of synechia formation in girls are considered to be the low level of female sex hormones (estrogens) characteristic of a child’s body and poor hygiene. In some cases, the formation of synechiae in girls is accompanied by metabolic disorders, intestinal diseases (especially often intestinal dysbiosis), allergic processes and helminthic infestations. The formation of synechiae can also be affected by:

untimely replacement of diapers,

frequent and generous use of creams containing zinc oxide;

wearing clothes made of synthetic fibers by a child;

Synechiae usually develop in children under 8 years of age, but are most often identified between birth and 2 years of age.

What should mothers of girls pay attention to?

With timely diagnosis, synechia does not cause discomfort to the baby, is easy to treat and goes away without a trace. However, advanced cases can have serious consequences, so it is important for parents to pay attention to the condition of the genital organs and the general well-being of their daughter and, at the first sign of concern, contact a pediatric gynecologist.

Consultation with a doctor is necessary if:

the girl constantly experiences difficulty urinating (cries, strains, complains, avoids going to the potty);
there are even minor changes of any nature in the genital area, including redness, irritation or peeling.

Expert commentary

Firstly, if you notice any changes in the structure of the genital organs in your baby or something is not clear to you, do not be shy and do not think that this is how it should be. Consult a pediatric gynecologist for advice.

Secondly, if the baby has difficulty urinating: she strains, experiences discomfort, is capricious, cries, and this is accompanied by almost every act, it is necessary to sound the alarm. Don’t chalk it up to the fact that your child refuses to sit on the potty because he’s capricious. Perhaps this is a signal.
Thirdly, regularly examine the baby’s genitals - this should be part of a set of hygiene measures. If you experience rashes, redness, peeling or discharge, do not assume that everything will go away on its own. The hope of coping with the problem using home methods most often does not come true. Incorrect or late treatment can lead to complications.
If you have any complaints or questions related to the condition of a girl’s genital organs, immediately contact a gynecologist for children and adolescents for clarification!

Diagnosis of synechiae

If you find any warning signs in your child, do not hesitate - one visit to the doctor will dispel your doubts. To diagnose synechiae or exclude this diagnosis, an examination by a pediatric gynecologist is sufficient. To determine the cause of the disease, the doctor will order tests and, taking into account their results, prescribe comprehensive treatment. But perhaps no treatment is required and the doctor will only recommend regular monitoring and strict hygiene.

Expert commentary

Synechiae in girls is very easy to detect - to make a diagnosis, it is enough to examine the external genitalia. Synechiae in girls looks like a thin whitish-gray film connecting the lips. The film may be on a very small area of the lips, but it can also cover the entire entrance to the urethra and vagina.

To find the causes of the fusion, the pediatric gynecologist often prescribes a series of tests, including:

smear analysis (to determine the nature of the inflammatory process),

general blood and urine analysis,

stool analysis for dysbacteriosis,

feces for worm eggs and scrapings for enterobiasis,

blood sugar test.

Possible consequences of the formation of synechiae

Timely treatment will avoid negative consequences. However, it is important to understand: synechias do not tolerate neglect. If the disease is neglected, it can lead to serious complications.

Expert commentary

The danger of this pathology is that when the labia minora and labia majora stick together in the vagina, a closed space is formed in which vaginal discharge accumulates. They, in turn, create a favorable environment for the development of bacteria, which first results in inflammation. Difficulty urinating contributes to the development of inflammation of the bladder (cystitis) or the urethra (urethritis).

Also, synechiae leads to improper formation of the labia, thereby having a direct impact on the reproductive system. In the future, the girl may have problems conceiving and bearing a child. There is also a high risk of developing infertility.

How to treat synechiae?

To treat synechiae, as a rule, a special ointment containing estrogen is prescribed. After completing the course, the duration of which is determined individually, the ointment is gradually replaced with the usual neutral baby cream recommended by the doctor. More serious situations may require surgery. In this case, synechiae are divided under local or general (in rare cases) anesthesia.