Complete Labial Adhesion in a Post-Pubertal Girl: A Case Report

Labial adhesion usually occurs in the infancy period and in prepubertal girls. It is a rare entity in reproductive age without any hypoestrogenism condition. Voiding dysfunction is a rare manifestation of these conditions. Here, we report a 19-year-old girl with complete labial adhesion presented with urinary retention. A 19-year-old virgin girl was referred to the obstetrics and gynecology department of Ghaem Hospital. She complained of urinary retention. Physical examination was normal except that was moderate hypogastric tenderness and a huge vesical globe. Genital examination revealed complete fusion of the labia minora in the midline, extended from the posterior fourchette to the region of the clitoris covering the entire vaginal introitus, urethral meatus, and clitoris. Despite the use of topical estrogen cream and surgical labial separation, re-adhesion occurred for the third time. Vulvar biopsy confirmed severe inflammation. Finally, topical anti-inflammatory medication improved the symptoms. Although labial adhesion is very rare in the post-pubertal period, it can successfully be managed by medical and surgical treatment.

Effects of Extracurricular Sports in Prepubertal and Pubertal Girls

The aim of this study was to analyse the effects of the type of extracurricular sport on the body composition, respiratory parameters, and physical condition in prepubertal and pubertal girls. Four hundred and eighty-five female athletes (aged 8–14) from different sports participated in this study. They were gathered into four groups according to the sport typology and maturity level: ‘prepubertal girls who practise collective sports’ (PRE-CS), ‘prepubertal girls who practise individual sports’ (PRE-IS), ‘pubertal girls who practise collective sports’ (PUB-CS), and ‘pubertal girls who practise individual sports’ (PUB-IS). The cardiorespiratory fitness (the 20 m shuttle run test, 20 mSRT), anthropometry, respiratory capacity (forced spirometry), handgrip, CMJ test, and stabilometry were collected. Prepubertal girls showed a lower muscle mass (kg) and fat mass (kg) than pubertal girls regardless of the extracurricular sports typology. PRE-CS and PRE-IS also showed a lower respiratory fitness and physical fitness than pubertal girls (p < 0.05). Pubertal girls did not show significant differences (p > 0.05) in any of the body composition, respiratory fitness, and physical fitness variables when comparing between collective sports and individual sports. The results show that extracurricular participation in these types sports by prepubertal girls can influence their body composition, respiratory fitness, and physical condition.

Urethral Prolapse in Prepubertal Girls in Port Harcourt, Nigeria: A Multicentre Study

Background: Urethral mucosa prolapse is a rare condition mainly seen in prepubertal girl with racial predilection for black girls. Methodology: This was a multicenter 7-year retrospective analysis of 27 cases of urethral mucosa prolapse treated at the university of Port Harcourt teaching hospital and private health facilities in Port Harcourt from 2011-2018. Relevant information extracted from the case files include age, clinical presentation, examination findings, treatment modality and post-operative complications. Data was entered and analyse using SPSS version 25 and results were presented in simple percentages and frequency tables Results: The institutional prevalence of urethral prolapse was 0.14%. The commonest presenting complaint was blood stains on the underwear in 23 (85.2%) patients while all patients presented with the characteristic ‘doughnut sign’ of a circumscribed fleshy mass surrounding the urethral meatus. All patients had intact hymen. Surgery was the primary treatment modality in 24 (88.9%) cases while conservative medical management was carried out in three (11.1%) patients. The success rate for surgical management was 100% and 33.3% for medical treatment. The commonest post-operative complication was dysuria reported in 7 (25.9%) cases and acute urinary retention was reported in one (3.75) patient. Conclusion: Urethral mucosa prolapse is a rare but important condition in prepubertal girls presenting with vaginal bleeding due to the suspicion of sexual abuse. Surgical treatment offers better outcome amongst the studied population.

Bladder Papilloma As A Rare Cause Of Urogenital Bleeding In A Prepubertal Girl

There are different causes of urogenital bleeding in prepubertal girls. These include vulvovaginitis, urinary infections, urethral prolapse, urethral caruncle, vaginal foreign bodies, hormonal causes, tumors, posterior labial fusion, lichen sclerosis. Among the tumors, rhabdomyosarcoma and papilloma are prominent. In this article, a case of urogenital hemorrhage due to papilloma located at the base of the bladder was presented and the relevant literature was reviewed

Vitamin D Status And Parathyroid Hormone Levels In Girls With Central Precocious Puberty

Background. The presence of vitamin D receptor in both the pituitary gland and female reproductive tissue suggests that vitamin D could be involved in female fertility mechanisms as well as in the activation of the hypothalamic-pituitary-gonadal axis. The objective of this study was to analyze the vitamin D status and PTH levels in 6- to 8-years-old girls with central precocious puberty. Methods. A cross-sectional clinical and blood testing (calcium, phosphorus, 25(OH)D and PTH) were carried out in 78 girls with central precocious puberty (CPP group), aged 6.1-7.9 years. A control group was recruited (157 prepubertal girls, aged 6.1-8.2 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D. Results. There were no significant differences in the vitamin D status between both groups. There were not significant differences in 25(OH)D levels between CPP (25.4±8.6 ng/mL) and control groups (28.2±7.4 ng/mL). In contrast, in CPP group PHT levels (44.8±16.3 pg/mL) were higher (p < 0.05) with respect to control group (31.0±11.9 ng/mL). In CPP group there was positive correlation (p < 0.05) between PTH levels and growth rate, bone age, basal estradiol, basal FSH, basal LH and LH peak. Conclusion: Vitamin D status in 6- to 8-years-old girls with CPP is similar to that in prepubertal girls. PTH levels were significantly higher in girls with CPP, and could be considered as a pubertal characteristic and, in this case, of pubertal precocity.

Haemophilus influenzae Vulvovaginitis in Prepubertal Girls: A 4-Year Study on a Tertiary Children’s Hospital in China

Background: Vulvovaginitis is a common infection in prepubertal girls, which is partly caused by bacterial infection. According to the literature, Haemophilus influenzae is one of the most common bacterial causes of vulvovaginitis in children. However, few studies with large sample sizes have delved into this issue. Objectives: To determine the prevalence of Haemophilus influenzae vulvovaginitis in prepubertal girls and detect the antimicrobial resistance of H. influenzae strains isolated from vulval specimens. Methods: The isolates of H. influenzae from the vulval swabs of prepubertal girls with vulvovaginitis were received from The Children’s Hospital, Zhejiang University School of Medicine, during 2016 - 2019. The vulval specimens were inoculated on Haemophilus selective chocolate agar, and antimicrobial susceptibility tests were performed by the disk diffusion method. Moreover, β-lactamase was detected using Cefinase disc. Results: In this study, 4142 vulval specimens were received during four years, of which 649 H. influenzae isolates had been isolated from 642 girls aged 6 months-13 years, with a median of 5 years. The peaks of isolates were observed from April to July in the vulval isolates. In general, the ampicillin resistance rate was 39.1% (250/640), 33.2% of strains (211/636) were β-lactamase-positive isolates, and 6.6% strains (42/635) were β-lactamase-negative ampicillin-resistant" (BLNAR)) isolates. The resistance rates of H. influenzae isolates to amoxycillin-clavulanic acid, ampicillin-sulbactam, cefuroxime, ceftriaxone, cefotaxime, meropenem, levofloxacin, sulfamethoxazole-trimethoprim, azithromycin, and chloramphenicol were 26.4%, 21.8%, 24.8%, 1.7%, 1.0%, 0.2%, 0%, 47.7%, 10.2%, and 1.1%, respectively. MDR was noticed in 41 persons (6.4%) out of the 642 H. influenzae isolates, with the most prevalent MDR phenotype of ampicillin-sulfamethoxazole-trimethoprim-azithromycin resistance. Conclusions: Clinicians should noticed that H. influenzae is a common bacterial cause of vulvovaginitis in children, and laboratories should routinely cover Haemophilus culture media for vulval specimens. The Ampicillin resistance of H. influenzae should also be considered in clinical management.

Vitamin D Status and Parathyroid Hormone Levels in Girls With Central Precocious Puberty

The objective of this study was to analyze the vitamin D status and PTH levels in 6- to 8-years-old girls with central precocious puberty. A cross-sectional clinical and blood testing (calcium, phosphorus, 25(OH)D and PTH) were carried out in 78 girls with central precocious puberty (CPP group), aged 6.1-7.9 years. A control group was recruited (157 prepubertal girls, aged 6.1-8.2 years). The criteria of the US Endocrine Society were used for the definition of hypovitaminosis D. There were no significant differences in the vitamin D status between both groups. There were not significant differences in 25(OH)D levels between CPP (25.4±8.6 ng/mL) and control groups (28.2±7.4 ng/mL). In contrast, in CPP group PHT levels (44.8±16.3 pg/mL) were higher (p < 0.05) with respect to control group (31.0±11.9 ng/mL). In CPP group there was positive correlation (p < 0.05) between PTH levels and growth rate, bone age, basal estradiol, basal FSH, basal LH and LH peak. Conclusion: Vitamin D status in 6- to 8-years-old girls with CPP is similar to that in prepubertal girls. PTH levels were significantly higher in girls with CPP, and could be considered as a pubertal characteristic and, in this case, of pubertal precocity.

The Effects of Exercise Serum From Prepubertal Girls and Women on In Vitro Myoblast and Osteoblast Proliferation and Differentiation

Purpose: In girls and women, the authors studied the effects of an acute bout of low-impact, moderate-intensity exercise serum on myoblast and osteoblast proliferation in vitro. Methods: A total of 12 pre/early pubertal girls (8–10 y old) and 12 women (20–30 y old) cycled at 60% VO2max for 1 hour followed by 1-hour recovery. Blood samples were collected at rest, mid-exercise, end of exercise, mid-recovery, and end of recovery. C2C12 myoblasts and MC3T3E1 osteoblasts were incubated with serum from each time point for 1 hour, then monitored for 24 hours (myoblasts) or 36 hours (osteoblasts) to examine proliferation. Cells were also monitored for 6 days (myoblasts) to examine myotube formation and 21 days (osteoblasts) to examine mineralization. Results: Exercise did not affect myoblast or osteoblast proliferation. Girls exhibited lower cell proliferation relative to women at end of exercise (osteoblasts, P = .041; myoblasts, P = .029) and mid-recovery (osteoblasts, P = .010). Mineralization was lower at end of recovery relative to rest (P = .014) in both girls and women. Myotube formation was not affected by exercise or group. Conclusion: The systemic environment following one acute bout of low-impact moderate-intensity exercise in girls and women does not elicit osteoblast or myoblast activity in vitro. Differences in myoblast and osteoblast proliferation between girls and women may be influenced by maturation.