Effect of topical estrogen cream compared with observation in prepubertal girls with labial adhesions

Background Topical estrogen treatment has been considered the first-line treatment of labial adhesions in prepubertal girls. However, the effect of topical estrogen cream is different according to studies, and no study compared estrogen cream to observation. Objective: This study aims to investigate the efficacy of topical estrogen cream treatment compared with observation in prepubertal girls with labial adhesions. Study design The medical records of prepubertal girls diagnosed with labial adhesions from April 2005 to June 2019 were retrospectively analyzed. Baseline characteristics such as age at diagnosis and initial symptoms were collected. The primary outcome was the resolution of labial adhesion. Secondary outcomes were recurrence and side effects. Results A total of 114 patients were enrolled and divided into two groups, topical estrogen cream (n=94), and observation (n=20). Girls who were treated with estrogen cream had older age (24.6±19.0 vs. 16.7±15.3 months, p=0.037) and higher resolution rate than the observation group (100.0% vs. 85.0%, respectively, p=0.005). Girls younger than 23.3 months showed a significantly higher resolution rate to topical estrogen treatment (100% vs. 86.7%, p=0.043). Side effects and recurrences occurred exclusively in children treated with topical estrogen therapy without significant differences compared to the observation group. Conclusion Topical estrogen therapy showed a higher resolution rate than observation for the treatment of prepubertal girls with labial adhesions, especially in younger girls.