An otherwise healthy 2 month old girl was referred to the outpatient office for the vaginal finding seen below.

 

 

 

The next best step in managing this vaginal anomaly is

 

A pelvic ultrasound

 

B vaginoscopy and vaginostomy

 

C serum electrolytes

 

D topical estrogen

 

E systemic steroids​

Labial adhesios

D topical estrogen

D

D

Correct answer

D topical estrogen

 

This baby has labial adhesion. Labial adhesion (also known as synechia vulvae) is the fusion of labia majora/minora. Low estrogen level is presumed to be a contributing cause. Although it is often asymptomatic, it has been occasionally associated with urinary problems. Several treatments include topical estrogen therapy (conjugated estrogen cream or estradiol vaginal cream 0.01% 2-3x a day for several weeks), steroid cream, or even manual separation. Recurrence during the prepubertal period is common and is treated topically or operative manual separation. Labial adhesion is not associated with serologic abnormalities or anatomic abnormalities of the internal or external female genitalia.

​

Totally agree of Dx and Rx

An otherwise healthy 2 month old girl was referred to the outpatient office for the vaginal finding seen below.

 

 

 

The next best step in managing this vaginal anomaly is

 

A pelvic ultrasound

 

B vaginoscopy and vaginostomy

 

C serum electrolytes

 

D topical estrogen

 

E systemic steroids​

 

D

D topical estrogen