Awareness about labia minora fusion among Lebanese pediatricians

The three main objectives of this study are to assess awareness about labia minora adhesion among Lebanese pediatricians, evaluate the number of those who perform a systematic gynecological examination in young girls and describe the management of this pediatric pathology in Lebanon in comparison with the literature review. Materials and methods: This is a cross-sectional descriptive study conducted in 2014 through a questionnaire that was answered by 117 pediatricians practicing in the different Lebanese regions. The data was analyzed on “Microsoft® Excel® 2013” in order to meet the three pre-described objectives. Results: 41% of the 117 pediatricians were familiar with the pathophysiology of labial adhesion. The lowest rates of awareness about this condition were reported in the South (7%) and Bekaa (13%). 80% of pediatricians routinely examine the female’s genitals. 26% of male pediatricians do not systematically examine female genitalia compared to 7.5% of female pediatricians (p = 0.02). 73% of the cases were discovered on a routine, systematic physical examination. The adhesion of the labia minora is associated in 23% of the cases with a urinary infection and in 16.65% with genitourinary symptoms. 9% of pediatricians made the diagnosis following the discovery by the mother. 83% of the doctors handled the case without a pediatric gynecology consult and then 42% referred the patient at a later time (to a pediatric surgeon in 82% of the cases). 17% initially adopt a conservative attitude; 75% apply creams with a recurrence rate of 16%. The highest rate of recurrence was observed in the case of manual separation (21%). Conclusion: The adhesion of labia minora is a common, benign, commonly asymptomatic, poorly recognized and underestimated condition in Lebanon. 1/5 of pediatricians, mainly males, do not examine the genital area of girls. 75% of the pediatricians resort to estrogenic creams or corticosteroids, and 17% are conservative.