Depending on the maturity of the child and the expectations of the parents, this can be performed in the office. Use EMLA cream and perform a blunt separation of the labia using a hemostat. In some cases, anesthetic sedation prior to the procedure is recommended. Since labial adhesions are rarely symptomatic or an emergent issue, patients should be allowed to follow-up in the office of the pediatrician, pediatric gynecologist or pediatric urologist. Diet is not associated with labial adhesion formation.
Activity has no association with labial adhesions.
Systemic side effects of estrogen are rare and reversible once the treatment is stopped. Dienestrol is a synthetic, non-steroidal estrogen. It is compounded in a cream base and is suitable for intravaginal use only. In adults, dienestrol is indicated for atrophic vaginitis. The usual dose is one to two intravaginal applications per day for one to two weeks followed by a maintenance dose of one to three times a week.