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Adhesion

Adhesion

Adhesion occurs when one type of molecule is attracted to a different molecule. Water exhibits adhesive properties in the presence of polar surfaces, such as glass or cellulose in plants. For instance, when water is poured into a glass, the positively charged hydrogen molecules of water are more attracted to the negatively charged oxygen molecules in the silica than to the oxygen in neighboring water molecules.
Capillary action is a result of water’s adhesive tendencies. When a narrow glass...

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Surgical Correction for Pediatric Epiblepharon and Trichiasis

Surgical Correction for Pediatric Epiblepharon and Trichiasis

Published on: July 8, 2025

Management Variation in Pediatric Labial Adhesions: A Retrospective Cohort Study.

Riley J O'Keefe¹, Sarah D Compton¹, Melina L Dendrinos¹

¹Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI.

The Journal of Pediatrics

|March 8, 2025

Summary

Nonsurgical treatment is effective for most labial adhesions (LAs). Management approaches showed minor differences between pediatric and adolescent gynecologists (PAGs) and pediatric urologists (PURs), with no significant variation in surgical intervention rates.

Keywords:

labial agglutination labial synechia pediatric gynecologist pediatric urologist vulvar adhesions

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Area of Science:

Pediatric Gynecology
Pediatric Urology
Adolescent Medicine

Background:

Labial adhesions (LAs) are common in pediatric patients.
Management strategies can vary among different medical specialists.

Purpose of the Study:

To compare treatment and outcomes for labial adhesions (LAs) managed by primary care providers (PCPs), pediatric and adolescent gynecologists (PAGs), and pediatric urologists (PURs).

Main Methods:

Retrospective cohort study of patients aged 0-21 years.
Analysis of management variations using cross-tabulations and statistical tests.
Inclusion criteria based on ICD-9/10 codes for LA.

Main Results:

159 patients analyzed; 81 managed by PCPs, 78 referred to specialists (41 PUR, 32 PAG).
Nonsurgical treatment was initial approach for all patients.
Surgical intervention rates did not differ between PAGs and PURs; PURs performed sharp adhesiolysis more often.

Conclusions:

Nonsurgical treatment remains effective for the majority of labial adhesion cases.
Minor variations exist in LA management between PAGs and PURs.
Further research could explore long-term outcomes across different management pathways.