Approach to labial fusion in children: 16 years of experience

Year 2022, Volume: 10 Issue: 1, 1 - 5, 15.03.2022

Can İhsan Öztorun , Elif Emel Erten , Süleyman Arif Bostancı , Şükrüye Demirkaya , Ahmet Ertürk , Sabri Demir , Doğuş Güney , Gülsen Keskin , Müjdem Azılı , Emrah Şenel

https://doi.org/10.21765/pprjournal.1036818

Cited By: 3

Abstract

Aim: We aimed to retrospectively evaluate the patients with labial fusion who presented to or were referred to the pediatric surgery clinic in a tertiary pediatric hospital.
Material and Method: Between 01/01/2005 and 31/12/2020, 889 patients admitted or consulted to the pediatric surgery clinic due to labial fusion, age at the time of diagnosis, complaints on admission, which clinic referred the patient to the pediatric surgery clinic, treatments, recurrence, and complications were evaluated retrospectively.
Results: The mean age of the patients was 2.21 (0.1–11) years. Most of the patients (82.5%) were asymptomatic. Parents noticed the condition and brought their child directly to the pediatric surgery clinic in 72.3% of the cases. Otherwise, patients were consulted to the pediatric surgery clinic from pediatric clinics, the pediatric endocrinology clinic, the pediatric nephrology clinic, or the pediatric emergency department. During the initial examination, manual separation was performed in 885 patients, and surgery was required for four patients. After the procedures, hydrotherapy with warm water and topical estrogen therapy were applied to all patients for 15 days. Recurrence was detected in 80 (9.0%) patients who were treated by manual separation. Manual separation was performed again in 78 of the patients, while surgical separation was performed in two (2.5%) patients who had severe fibrotic fusions.
Conclusion: In the treatment of labial fusion, we recommend the combination of manual separation and topical estrogen cream treatment because it can be applied safely in the clinic, and the recurrence rate is low. Surgical separation is preferred in severe, thick, and fibrotic labial fusions.

Keywords

girl, labial fusion, topical estrogen, manual separation, surgical separation

Çocuklarda labial füzyona yaklaşım: 16 yıllık deneyim

Abstract

Amaç: 3. basamak bir çocuk hastanesinde çocuk cerrahisi polikliniğine başvuran veya konsülte edilen labial füzyonlu hastaları retrospektif olarak değerlendirmeyi amaçladık.
Gereç ve Yöntem: 01/01/2005-31/12/2020 tarihleri arasında çocuk cerrahisi kliniğine labial füzyon nedeni ile başvuran veya konsülte edilen 889 hasta tanı anındaki yaşları, başvuru şikâyetleri, hangi kliniklerden çocuk cerrahisine konsülte edildiği, tedavileri, nüks ve komplikasyonlar açısından retrospektif olarak değerlendirildi..
Bulgular: Hastaların yaş ortalaması 2,21(0,1-11) yıl idi. Hastaların çoğu asemptomatik idi (%82,5). Hastaların %72,3’ü ebeveynlerin fark etmesi ile direk çocuk cerrahisi polikliniğine getirildi. Bunun dışında pediatri poliklinikleri, pediatrik endokrinoloji polikliniği, pediatrik nefroloji polikliniği ve çocuk acilden hastalar kliniğimize konsülte edildi. İlk muayenede, 885 hastaya manuel seperasyon ve 4 hastaya cerrahi uygulandı. Tüm hastalara işlemden sonra 15 gün boyunca ılık suya oturma banyosu ve topikal östrojen tedavisi uygulandı. Manuel seperasyon yapılan 80 (%9) hastada nüks tespit edildi. Nüks olan hastaların 78’ine yeniden manuel seperasyon yapılırken, sert fibrotik füzyonu olan iki hastaya (%2,5) ise cerrahi seperasyon yapıldı.
Sonuç: Labial füzyon tedavisinde, manuel seperasyon ve topikal östrojenli krem tedavi kombinasyonunu, poliklinik ortamında güvenilir şekilde uygulanabilir olması ve nüks oranın düşük olmasından dolayı önermekteyiz. Sert, kalın ve fibrotik labial füzyonlarda ise cerrahi seperasyon tercih edilmelidir.

Keywords

kız çocuk, labial füzyon, topikal östrojen, manuel seperasyon, cerrahi seperasyon

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