• Tuesday May 26,2020

Labiensynechie

In Labiensynechie the labia minora adhere to each other and can provide bacteria in the course of a breeding ground, so that urinary tract infections and even hydnephrosis are favored. The most common cause of the phenomenon is trauma to the epithelial layer. Treatment is by daily application of an ointment containing estrogen.

What is a lab sinechia?

About one third of all patients suffer from the adhesion of the labia minora frequently to urinary tract infections. Bacteria accumulate in the adhesion area of ​​the labia minora and enter the urinary tract where they cause inflammation.
© nmfotograf - stock.adobe.com

As labia minora the labia minora are called. A synechia knows the medicine as bonding. If the Labia minora adhere completely or proportionally to each other, there is talk of a so-called Labiensynechie. The prevalence of the disease is given as two to five percent. Above all girls are affected between the third month and the fourth year of life.

The Labiensynechie reaches its summit between the 13th and the 23rd month of life. In some cases, the labia nephritis may also exist immediately after birth. In a synechia of Labia minora, however, there are no direct adhesions. This relationship distinguishes the labia necus from any malformations due to a genetic cause, external factors during pregnancy and disturbances in embryonic development.

causes

A Labiensynechie can have different causes. For example, trauma leads to abrasion of the superficial epithelial layer. In this way, it can lead to scarring, which leads to the adhesion of the two labia. In this context, types of trauma include inflammations such as vulvitis or vulvovaginitis.

The cause of such inflammations may be poor hygiene. Seborrhoea or atopic dermatitis can also cause inflammatory reactions. The same applies to pinworms, a laceration of the labia minora or a spagath. In addition, sexual abuse and masturbation as causes of the trauma in question.

In isolated cases, estrogen deficiency is the primary cause of a labia neuropathy. With such a deficiency, the strength of the epithelial cells may diminish. Traumas of the labia are thereby at least favored.

Symptoms, complaints & signs

The labia neuropathy manifests clinically in different symptoms. Especially symptomatic is the abnormal micturition. In addition to a deviating urine stream in the actual act of micturition, a strong Nachträufeln occur after micturition. In addition, obstruction has been reported in some cases, which may be associated with bladder enlargement or hydronephrosis.

About one third of all patients suffer from the adhesion of the labia minora frequently to urinary tract infections. Bacteria accumulate in the adhesion area of ​​the labia minora and enter the urinary tract where they cause inflammation. Around 20 to 40 percent of patients are affected by this symptom. The manifestation may alternatively correspond to an asymptomatic bacteriuria.

In this case, although bacteria accumulate, they are eliminated with the micturition and cause no urinary tract infections or other complications. Since vulvitis is considered to be a possible cause of labia neuropathy, in some cases such inflammation may complete the clinical picture.

Diagnosis & disease course

The diagnosis of a labial synechia is based on the clinical picture. Since most girls with small labia adherence tend to remain relatively asymptomatic, the doctor often diagnoses synechia as a chance finding during a routine examination. Urogenital shows a flat vulva and adherent labia from the midline to the clitoris.

The labia of the labia seems to be thin above the introitus and hymen. The prognosis for affected patients is favorable. The above-mentioned symptoms such as the deviating urine stream, the Nachträufeln, the bacteriuria and the urinary tract infections usually occur late in the course. After early detection and subsequent treatment, most patients remain completely asymptomatic. Further clarification is usually not indicated for adhesion of the labia minora.

complications

As a rule, due to labia nephritis, urinary tract infections occur. These infections can be very unpleasant and, for example, lead to a painful urination. Not infrequently, the patients are ashamed of this complaint and suffer from burning pain. Due to the persistent pain, it can also lead to depression or other mental disorders and complaints.

Furthermore, the intercourse of the patient due to the Labiensynechie is significantly restricted, so it can lead to tension in a relationship. The quality of life of the person affected is significantly reduced and reduced by this disease. In most cases, the treatment of this disease is carried out with the help of medications, creams and ointments. The treatment usually leads to a success and there are no special complications or other complaints.

As a rule, a positive course of disease sets in. Only in rare and serious cases, those affected are dependent on surgery. The life expectancy of the patient is not reduced or limited. Further complications do not occur either.

When should you go to the doctor?

Women who have urinary problems should talk to the gynecologist. Medical advice is also needed if you have recurrent urinary tract infections or other unusual genital symptoms. Symptoms that persist for a long time or recur after a symptom-free period indicate a serious condition, such as labia nephritis, and therefore need to be investigated. Burning pain when urinating as well as problems with sexual intercourse are an indication that the disease is already advanced.

To avoid further complications, the affected women should talk to the gynecologist immediately. Parents who notice signs of a labia neuropathy in their child should not hesitate to visit the doctor. Inflammations in the genital area and hormonal complaints are possible triggers of bonding the labia. Even a worm infestation and eczema in the vagina are among the conceivable causes that need to be clarified. If the complaints in connection with the mentioned diseases on, is best consulted directly to a specialist. In addition to the gynecologist, an internist or a dermatologist can be visited.

Treatment & Therapy

A labial neuropathy is never solved manually. The risk of traumatic injury to the epithelial layers is high with a manual adhesion solution. Often scars remain behind and a second adhesion can be favored. No more than the manual solution is an operative separation of the labia indicated.

The treatment is conservative and is limited in asymptomatic cases on the therapy by means of conjugated cream of the active substance estrogen. Especially often Premarin is used. The patient or parents of the patient are instructed to place smaller amounts of cream on the site of adhesion each day. Depending on the strength of the adhesion, it may also be necessary to apply the cream twice a day.

As a rule, this treatment resolves the small labia syndrome within one month at the latest. The cream treatment has a success rate of around 90 percent. If there is already a urinary tract infection, the patient will also be prescribed antibiotics to combat bacterial colonization. The same applies to the presence of vulvitis. Surgery is indicated solely for obstruction with hydronephrosis. The procedure eliminates the obstruction and ideally dissolves hydronephrosis.

Outlook & Forecast

The prognosis in a Labiensynechie is usually very favorable. The life expectancy is not limited by the disease and there are no long-term consequences. Affected girls under the age of six often experience rapid healing without further complications.

In many cases, the bonding of the labia dissolves within a few weeks or months by itself. In some patients she is completely asymptomatic during this time. It is not always necessary to treat the labial sinus with medical treatment. The treatment usually leads quickly to success. The treatment with estrogen-containing creams causes a rapid improvement in symptoms. Within a few weeks the Labiensynechie dissolves completely.

Especially when premature termination of therapy, it may happen that the labia again stick together. The repetition of treatment usually leads to complete healing. If the disease is not treated for a long time despite severe symptoms, however, complications may occur. This rarely requires surgical treatment, which is usually performed on an outpatient basis. The prognosis is generally very good. However, there may be scarring of the affected tissue, which usually heals within a few months.

prevention

To prevent a Labiensynechie, is a prophylactic treatment steps available. This prophylaxis is used especially if after a small labia adhesion and its dissolution a recurrence should be prevented. The most common prophylaxis is the order of Vasiline, which occurs once a day in the area of ​​the previous adhesion. If there has never been an adhesion in the past, preventive measures are generally not required.

aftercare

In the case of a labia neuropathy, the patient usually has few or even no special options for follow-up care. First and foremost, a quick diagnosis and treatment of the disease should take place, so that no further complications and complaints can occur. A self-healing usually can not occur, so always a treatment by a doctor must be done.

In most cases, the disease is treated by the application of a cream. In doing so, the people concerned should pay attention to a correct application and also to a correct dosage of these medicines. In many cases, the parents in children have to control the right application so that the complaints are properly and, above all, permanently alleviated.

Since the Labiensynechie is accompanied in many cases with a strong sense of shame and also with a reduced self-esteem, loving and intensive discussions with the child are very helpful and important. Also, the contact with other stakeholders may be useful, since it comes to an exchange of information. These can then facilitate the everyday life of the patient. As a rule, the labial sinus does not reduce the life expectancy of the patient.

You can do that yourself

In general, in a Labiensynechie no special ways of self-help are possible or necessary. The treatment of the disease is carried out with the help of creams and ointments, surgical intervention is not necessary. The cream should be applied at most twice a day so as not to irritate the skin.

As the labial nephritis can also lead to a urinary tract infection, the patient should visit her gynecologist or a urologist to avoid further discomfort. The treatment of these infections is usually carried out with the help of antibiotics. The person concerned should refrain from alcohol and possibly treat possible interactions with other medicines. In order not to delay the treatment of Labiensynechie, the person should also abstain from sexual activities during this.

For mental health problems, depression or inferiority complexes, conversations with close friends or with the partner are suitable. Above all, the reduced self-esteem can be increased very often. Possibly also the exchange of information with other affected persons can contribute to a positive course of the illness. However, psychological treatment is necessary if the labia neuropathy has occurred as a result of sexual abuse.


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