ABSTRACT
A1 A Labial adhesions (also known as labial agglutination) occur in prepubertal girls with a peak incidence at 13-23 months of age, but can occur as early as 3 months and up to 6 years of age. The overall incidence of labial adhesions in prepubertal girls is 1.8%–7% but may be higher in select populations. The pathophysiology of labial adhesions may involve poorly regulated wound-healing, with re-epithelialisation resulting in an avascular adhesion, essentially cross healing areas of denuded epithelium and fusing the labia minora which are naturally in close apposition. Labial adhesions are associated with any condition that traumatises, irritates or inflames the unoestrogenised prepubertal labia; for example, vulvovaginitis, dermatological conditions, local irritants and recurrent diarrhoea. Labial agglutination is a non-specific vulvovaginal condition and therefore is not a definite indicator of sexual abuse. Labial adhesions that occur after puberty are much less common; they are usually a result of trauma or a surgical procedure to the labia and are hence of a different pathophysiology.
