Association between Functional Constipation and Primary or Recurrent Labial Adhesion in Prepubertal Girls: A Cross-Sectional Study.

BACKGROUND

The exact etiology of labial adhesion (LA) is unknown; however, it is obvious that the disease has multifactorial causes. Although several local and inflammatory factors have been implicated, the potential contribution of functional constipation (FC) has not been previously investigated. The aim of this study is to investigate the role of FC in the etiology of primary and recurrent LA.

METHODS

This cross-sectional analytical study included 2828 consecutive prepubertal girls evaluated in a pediatric surgery outpatient clinic between May 2021 and December 2024. Patients with inflammatory, dermatologic, traumatic, endocrine, or congenital conditions potentially affecting genital anatomy were excluded. Prevalence, relative risk (prevalence ratio), crude odds ratio, and attributable risk were calculated. Multivariable logistic regression adjusted for age was performed to assess independent association.

RESULTS

The overall prevalence of LA was 5.1% (145/2828). FC was present in 17.0% of the total study population. The prevalence of LA was significantly higher in children with constipation (11.4%) compared with those without (3.8%) (P < .001). The relative risk was 2.97 (95% CI: 2.16-4.10). After age adjustment, FC remained independently associated with LA (OR: 2.6; P < .001). The attributable risk percent was 66.4%. Recurrence was observed in 3.4% of patients during follow-up and was more frequent among children with constipation.

CONCLUSION

Functional constipation was significantly associated with both primary and recurrent LAs, and may represent a potential contributing factor. Evaluation of bowel habits may be clinically relevant in patients presenting with LA.