Lysis of labial adhesions
CPT4 code
Name of the Procedure:
Lysis of Labial Adhesions
Common name(s): Separation of labial adhesions, Adhesiolysis of labia minora.
Summary
Lysis of labial adhesions is a minor surgical procedure to separate fused labia minora (the inner lips of the vulva) typically seen in young girls. The procedure helps restore the normal anatomy of the vulva and prevent associated problems.
Purpose
Lysis of labial adhesions addresses the condition where the labia minora stick together, causing difficulty with urination, discomfort, or recurrent infections. The goal is to separate the labia, relieving symptoms and preventing future complications.
Indications
Labial adhesions may require this procedure if they cause:
- Difficulty with urination.
- Recurrent urinary tract infections.
- Vaginal discomfort or pain.
- Hygiene issues due to trapped secretions.
- Parental concern about anatomical appearance or function.
Preparation
- Typically, no fasting is required.
- Parents may be instructed to apply estrogen cream prior to the procedure to help thin the adhesions.
- A physical examination by a healthcare provider to assess the extent of adhesions.
Procedure Description
- The patient is placed in a comfortable position, often lying on her back.
- Local anesthesia is administered to numb the area.
- A small instrument or a sterile cotton swab is used to gently separate the fused labia.
- In some cases, a topical steroid or estrogen cream is applied to prevent re-adhesion.
- The area is cleaned, and post-procedure care instructions are provided.
Duration
The procedure typically takes about 10-15 minutes.
Setting
This procedure is usually performed in a pediatrician’s office or an outpatient clinic.
Personnel
- Pediatrician or a pediatric gynecologist.
- Nursing staff for assistance and comfort measures.
Risks and Complications
- Minor bleeding.
- Pain or discomfort.
- Recurrence of adhesions.
- Infection (rare and usually preventable with proper hygiene).
Benefits
- Relief from urinary and hygiene problems.
- Reduced risk of recurrent infections.
- Improved physical comfort.
- Greater ease of maintaining hygiene.
Recovery
- Application of a prescribed ointment to prevent re-adhesions.
- Regular follow-up visits to monitor healing.
- Most children can resume normal activities the same day.
- Pain or discomfort is usually minimal and manageable with over-the-counter pain relief if needed.
Alternatives
- Observation and use of topical estrogen cream without surgical intervention.
- Manual separation by parents with guidance from a healthcare provider.
- Consideration of non-surgical alpha-hydroxycarboxylic acid treatment for mild cases.
Patient Experience
During the procedure, the child might feel minimal discomfort due to the numbing effect of the local anesthesia. After the procedure, there may be slight soreness or sensitivity, which can usually be relieved with topical ointments or mild pain relievers. Parents are provided with comfort measures and clear instructions to ensure a smooth recovery.