labia fusion
Introduction
Introduction The so-called labial fusion is the vulva part of some little girls, especially the labia minora, which stick together and do not separate as normal. Some of the labial fusions are partially adhered, while others are almost completely closed. Therefore, the appearance of labial fusion often causes various degrees of urinary tract symptoms. At the same time, if not carefully examined, it is often overlooked and treated as other conditions. Clinically, these girls often have difficulty urinating, frequent urination or falling urine. In the case of urine culture, bacterial growth can be seen, with E. coli being the most common and manifested in acute inflammation. Some children have a urinary tract obstruction, so that when the urine is relieved, it is intermittent and there is a situation in which the urine flow is interrupted. In addition, some children stick to the opening of the urethra because the labia sticks together, so they will spread out like a sprinkle when they urinate, and will drip out after the urine is finished, so that the underwear is wet. Even some urine will collect in the vagina and then slowly flow out.
Cause
Cause
The cause of labial fusion:
Mainly secondary to infantile genital injury and inflammation, other such as congenital malformations, trauma, senile vaginitis, vulvar white lesions, etc. can also be caused.
The labia fusion is usually the result of chronic inflammation of the female genital area, so that the labia minora adheres to each other and becomes closed. These symptoms are rarely manifested at birth. Some girls' labia fusion is asymptomatic and therefore not easy to check out. Some may show symptoms of urinary tract obstruction or manifest as a urinary tract infection.
Under normal circumstances, the labia minora is in contact with each other. For babies and young girls, the outer surface is covered with a fine, rather than keratinized, squamous epithelium. This phenomenon, especially after the mother's action of estrogen is degraded, becomes more real. At this time, if a meaningful injury occurs, or an infection or inflammation occurs, the surface of the labia minora will be eroded and agglomerated with each other, causing adhesion. As a result of the adhesion of the labia, it will extend upward from the posterior labial ligament to the end of the clitoris, leaving only a small hole in the opening. The final result will cover the area of the vaginal vestibule and the hymen, as well as the position of the urethral opening. The position of the bond is at the center line, presenting a thin, translucent film.
Examine
an examination
Related inspection
Sex hormone binding protein chromosomal 17- ketogenic steroid urinary 17-keto steroid
Examination and diagnosis of labial fusion:
In terms of physical examination, the vulva part of these little girls can be seen, and the labia minora is completely glued together, so that there is no way to observe the internal vagina. With a slight adhesion, a thinner and translucent film can be seen, sometimes a denser and fibrous commissure. As for the clitoris, it is usually buried inside, so that there is no way to be seen or touched. If you use ultrasound scanning to check, you can see that the bladder wall will become thicker, indicating that some people will be affected by urinary tract obstruction. However, from the perspective of urethral urethrography during urination, it is not possible to cause a ureteral reflux.
The labia fusion usually does not have any symptoms, but sometimes it can cause inflammation. The result is an incorrect judgment, which is thought to be a urinary tract infection. Because the urine comes out, it will collect in the vagina, so that the urine sample taken is contaminated, and the infection is judged. There are a few cases that may even cause an error diagnosis of vaginal atresia, which causes a great burden on the child's parents.
Physical examination focus: mainly the genital examination, observe the development of the vulva, skin color, clitoris size, with or without deformity.
Important auxiliary examination: For genital malformations, karyotype analysis, sex hormones and 17-ketosteroids should be performed. In the case of a vulvar at the same time, a biopsy should be performed to determine the cause.
Diagnosis
Differential diagnosis
Symptoms of labial fusion that are confusing:
Due to the reduction of dysfunction of the nerve center caused by inflammatory tumors, necrosis or surgery in the nerve center, the secondary dysfunction of the thyroid gland and adrenal cortex causes a disorder of the endocrine system and the nervous system, and thus the female Breast and genital atrophy.
Sexual malformation refers to the sexual performance of an individual's sexual organs. The reason for this is due to sex chromosome aberrations, and abnormal secretion of androgen leads to abnormal development of sexual organs in the embryo. If the same body has both testicles and ovaries, the external genitalia and the second sexual characteristics are between the two sexes, called true hermaphroditism. If the gonads are not consistent with the external genitalia, they are called pseudohermaphroditism. If the external genitalia is similar to a female and the internal genital is a matter of nine, it is called a male pseudohermaphroditism. On the contrary, the external genitalia is similar to the male, and the internal genitalia is the ovary, which is called female pseudohermaphroditism.
In terms of physical examination, the vulva part of these little girls can be seen, and the labia minora is completely glued together, so that there is no way to observe the internal vagina. With a slight adhesion, a thinner and translucent film can be seen, sometimes a denser and fibrous commissure. As for the clitoris, it is usually buried inside, so that there is no way to be seen or touched. If you use ultrasound scanning to check, you can see that the bladder wall will become thicker, indicating that some people will be affected by urinary tract obstruction. However, from the perspective of urethral urethrography during urination, it is not possible to cause a ureteral reflux.
The labia fusion usually does not have any symptoms, but sometimes it can cause inflammation. The result is an incorrect judgment, which is thought to be a urinary tract infection. Because the urine comes out, it will collect in the vagina, so that the urine sample taken is contaminated, and the infection is judged. There are a few cases that may even cause an error diagnosis of vaginal atresia, which causes a great burden on the child's parents.
diagnosis:
First, the history of the main points:
1. Pay attention to the initial situation and development process of the onset of the disease, whether it has been treated and treated.
2. Whether there is a history of traumatic or topical corrosive drugs, whether there is genital itching, increased vaginal secretions and abnormal urination.
3. For infants and young children, ask the parents if they have urinary dysfunction, the urine flow deviates from the direction, crying or disturbing or scratching the vulva.
Second, physical examination focus: mainly genital examination, observe the development of the vulva, skin color, clitoris size, with or without deformity.
Third, important auxiliary examination; for vulvar developmental deformity, karyotype analysis, sex hormones and 17-ketosteroids should be measured. In the case of a vulvar at the same time, a biopsy should be performed to determine the cause.
