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Labial fusion is a common benign pediatric gynecologic condition that is defined as partial or complete adherence of the labia minora. The fusion is usually midline and appears as a thin pale translucent streak. It almost never occurs in the newborn and is most uncommon after 5 years of age. The peak incidence is somewhere between 1- 2 years of age and although the cause is not known, this age distribution supports an acquired etiology as a result of an inflammatory condition such as a vulvovaginitis. The uncommon occurrence beyond 5 years of age suggests that spontaneous resolution is the norm for this condition and that treatment may not be required before this age. If treatment is deemed to be necessary then a topical oestrogen preparation such as Premarin is often effective. Oestrogen levels are much higher in infants less than three months of age and in children older than 5 years of age than at other times, and this may explain why the labial fusion is uncommon at these ages. The only genitourinary problems that may be associated with labial fusion are urinary tract infection (UTI) and asymptomatic bacteriuria. A higher index of suspicion for UTI should be considered in children with labial fusion but otherwise no other investigations are required.
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