How should we treat prepubertal labial adhesions? Retrospective comparison of topical treatments: estrogen only, betamethasone only, and combination estrogen and betamethasone.

Labial adhesion is a common finding in prepubertal girls. Traditionally, topical estrogen cream application has been the choice of conservative treatment, however, topical betamethasone treatment has also recently been employed with some success. In this retrospective study, we analysed 131 children with labial adhesions. Eleven of 71 (15.4%) patients were treated successfully with topical estrogen cream only, and 5 of 32 (15.6%) patients were treated successfully with betamethasone cream only. We successfully treated 5 of 28 (28.5%) patients with a combination of estrogen and betamethasone creams. The mean time of treatment for each regimen of therapy was 4 weeks. There was no significance between the single-therapy estrogen and single-therapy betamethasone groups (P = 1.00), between single-therapy estrogen and the combination therapy (P = .16), and the single therapy betamethasone to combination therapy (P = .35) groups. There was also no significant difference between combination estrogen and betamethasone therapy and the combined data of the single therapies (relative risk 1.85; 95% confidence interval 0.89-3.89; P =.11). For the treatment of prepubertal labial adhesions, topical estrogen and betamethasone creams were found to have similar success rates, with limited satisfactory results. The combination therapy was mildly more efficacious than each of the single therapies but was not found to be statistically significant. Surgical separation is recommended if conservative treatment fails.