Management Variation in Pediatric Labial Adhesions: A Retrospective Cohort Study
Abstract
OBJECTIVE
To compare treatment and outcome differences between primary care providers (PCP), pediatric and adolescent gynecologists (PAG), and pediatric urologists (PUR) in management of labial adhesions (LA).
STUDY DESIGN
This was a retrospective, cohort study of patients aged 0 through 21 presenting for a clinic visit from July 2022 to July 2023 at a single institution, identified by ICD-9/ICD-10 codes for LA. Management variation was analyzed via cross-tabs with chi-square, Fisher's exact, and two-sample t-tests.
RESULTS
The 159 patients meeting inclusion criteria had a median age of 12 months at diagnosis; 81 were managed by a PCP and 78 were referred to a specialist: 41 (52.6%) PUR, 32 (41.0%) PAG, and 5 (6.4%) other specialists. Forty-one patients presented with urinary issues, with no difference in rate of referral to PUR (37.8%), PAG (15.5%), or continued PCP management (46.7%), P=.17. All patients were initially treated nonsurgically. Surgical intervention rates did not differ between PAG and PUR (P=.21). PUR performed sharp adhesiolysis more often than PAG (P=.011), but there was no difference in blunt adhesiolysis rates between PAG and PUR (P=.17). LA recurred postoperatively in 6 (3.8%) patients.
CONCLUSIONS
These results reiterate the efficacy of nonsurgical treatment for most patients with LA and illustrate minor variation in LA management between PAG and PUR.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 159 participants or records.
Read the paper
Related studies
- Characterization and Analysis of Porosity and Pore Structures
- Practical considerations for conducting ecotoxicity test methods with manufactured nanomaterials: what have we learnt so far?
- Dental Optical Coherence Tomography
- Radiation-shielding concrete: A review of materials, performance, and the impact of radiation on concrete properties
- Testing entanglement of annihilation photons
- Calanus finmarchicus seasonal cycle and diapause in relation to gene expression, physiology, and endogenous clocks
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.