Dr. Komarovsky on synechia in girls

The term "synechia" may not be familiar to you, but it’s a crucial subject for children’s health. Renowned pediatrician Dr. Komarovsky has provided insightful information about this illness, particularly as it relates to girls. For parents who are worried about their child’s wellbeing, it can be essential to comprehend synechia and know how to treat it.

We’ll look at Dr. Komarovsky’s viewpoint on synechia, a condition in which the labia may become stuck together, in this article. It’s critical to understand the symptoms, underlying causes, and suggested therapies in order to protect your child’s wellbeing. By paying attention to professional advice, you can improve your readiness to deal with any issues that may come up.

What is it

Synechia in girls is a cosmetic defect in the intimate area, in which there is a fusion of the labia in a certain fragment, more often in the lower third, or along the entire length. Not only can the labia majora join, but in certain situations, the labia minora and labia majora can also join. At times, the urethra’s openings are completely fused, making it impossible to see them at all. Other times, just the vagina is closed.

Since the child doesn’t feel any pain, itching, or other unpleasant sensations during the fusion process, even vigilant parents have trouble pinpointing the precise start of the process. The diagnosis is typically made after the fact, when the child has been examined by a pediatric gynecologist and they start discussing synechia. This typically occurs when a child registers for kindergarten or school.

Evgeny Komarovsky estimates that 1-3% of girls worldwide suffer from this issue. Only official data, mostly found on paper, is included here. The doctor said that in actuality, the number of these babies in a given clinic might be as high as 35–40%. This is because of the way a specific physician handles synechia symptoms: if you look closely, almost all infants under two years old have some degree of adhesion.

Therefore, adhesions in girls shouldn’t be regarded as a disease, according to Dr. Komarovsky. Instead, this is an early childhood physiological trait, and the diagnosis is not horrifying in the slightest. This does not apply in situations where the adhesion is so strong that it makes it difficult or disrupted for pee to flow out. Serious gynecological inflammatory processes may result from this. Komarovsky is certain that synechiae in early childhood do not generally affect the ability to reproduce later in life.

Causes

Modern medicine still does not fully understand the causes of synechia, though a number of specialized reference books suggest a link between the inflammatory process in the external reproductive organs and the labia’s subsequent fusion. Therefore, an allergic response or bacterial inflammation may act as a catalyst for fusion.

Certain gynecologists observe that babies who receive multiple daily soap washes from loving parents are more likely to develop synechia. Such hygienic practices cause microtraumas to the delicate labia skin, which heal to cause fusion.

Doctors say that wearing synthetic clothing can also cause synechia to form in girls. The type of washing powder that a mother uses to wash her child’s clothes also matters; if it contains harsh ingredients, synechiae may result from long-term chemical irritation that causes chronic inflammation in the daughter’s genitalia.

Today, one of the most compelling explanations for synechia is thought to be the typical low level of the female sex hormone estrogen in young girls. Due to their ample supply of maternal sex hormones, newborn babies rarely experience fusion of the labia; however, by six months of age, the risk of synechia rises.

According to Dr. Komarovsky, girls’ synechia, or the fusion of the labia, is a common and generally benign condition that can be treated with the right attention. He emphasizes that parents should seek medical advice if the condition persists or causes discomfort, but otherwise should concentrate on hygiene and gentle treatment.

Symptoms

A thin, translucent film connecting the fused labia is the only known sign of synechia, and it is also the most noticeable. If they look closely, almost all parents and doctors can see it. To make a diagnosis, no additional research or tests are required.

If vulvitis or vulvovaginitis is combined with the fusion, the girl will most likely experience itching in the genital area, discharge with an unpleasant odor, and redness that is unmistakable.

Treatment

According to Evgeny Komarovsky, you cannot consider treating a child if he does not complain about anything, if he is not bothered by pain or itching, or if he has no issues urinating. A gynecologist visit should be made periodically to monitor the degree of fusion. There’s no need to rush into surgery because the girl will produce female sex hormones (estrogens) at the start of puberty, which is after 7 years. Under their influence, the labia will become more elastic, and the fusion issue will resolve itself. About 80% of girls have this result.

The remaining portion will require medication treatment during adolescence in the form of an estrogen-containing ointment called "Ovestin," which must be applied over the course of several weeks. The medicated cream is gradually swapped out for any neutral cream free of dyes and fragrance additives. It is applied following a bath.

This is how the typical treatment plan looks:

• the first 2 weeks "Ovestin" is applied twice a day;
• the next 2 weeks the ointment is rubbed in once a day, for the second treatment use regular baby cream;
• In the future, Ovodin is canceled, only a children"s cream or another neutral cream is left, provided that the bluechies were divided.

Only the fusion area should be touched when rubbing the preparation; cotton wool or sticks should not be used. Additionally, the preparation should not come into contact with surrounding areas. Applying the ointment gently is advised, but you also need to make sure the child is not in any pain. Pressure is just as significant as the actual ovestin.

When using ointments and creams containing estrogen, these actions are typically not noticed; only a small percentage of small patients may experience mild labia swelling. It vanishes after more usage.

When synechiae cause pain, unhealthful vaginal discharge, or difficulty urinating, they should be treated right away. It is important for parents to keep in mind that they are under no obligation to take their child to the surgeon right away in such circumstances. First, the child must receive therapy with specific ointments containing estrogen; a mechanical separation will only occur if the therapy proves ineffective.

Mothers are urged by Evgeny Komarovsky not to consent to the mechanical separation of adhesions by hand, even though pediatric gynecologists frequently advise doing so. If your physician is among them, it is preferable to locate another physician who understands that, in the twenty-first century, instruments should be used for separation rather than fingers, and that the girl should unquestionably anesthetize the labia beforehand.

Dr. Komarovsky advises you to take an estrogen ointment course after a well-executed procedure in order to prevent re-fusion. Medical statistics indicate that following labiaplasty surgery, there is a roughly 30% chance of recurrence.

The understanding of synechia in girls provided by Dr. Komarovsky clarified a condition that frequently causes parents to worry. His method places more emphasis on comprehending the problem and treating it carefully than it does on prescribing needless therapies.

He emphasizes that synechia—the adhesion of vaginal tissues—is a rather common condition that typically goes away on its own. When a child exhibits symptoms, parents should monitor them and get medical help if there are any indications of discomfort or other problems.

In summary, Dr. Komarovsky reassures parents that although synechia can be concerning, it is usually controllable and doesn’t necessitate immediate action. Having a pediatrician check up on you on a regular basis will help guarantee that any possible issues are dealt with quickly and effectively.

Video on the topic

Is it harmful to wash girls often? – Dr. Komarovsky

What should you wash girls with and how often? – Dr. Komarovsky

Adhesions in girls

Adhesions (fusion) of the labia minora in girls. Advice for parents – Union of Pediatricians of Russia.

When and why synechiae (fusion of the labia) occur? – Dr. Komarovsky