Genital herpes is a common sexually transmitted disease in adolescents. It may be associated with significant morbidity if not diagnosed on time or not properly treated. The objective of this study was to determine the incidence of labial adhesion secondary to primary herpes in young women and the possible predisposing factors for this complication. The method was analysis of clinical data regarding primary genital herpes in young women seen in an adolescent outpatient clinic at a university hospital. Cases of primary genital herpes seen between December 1st 1998 and November 30th 1999 were included. A total of 34 female adolescents with age range 12 - 19 years were diagnosed with primary genital herpes during this time period. Seven patient (20.6%) were found to have severe labial adhesion at time of diagnosis. All seven patients were seen by other providers prior to their evaluation in the adolescent clinic, and four were correctly diagnosed. All seven patients were given antiviral therapy, but none were given local treatment. At time of diagnosis all seven patients had urinary retention for more than 24 hours and sever pain and discomfort. Three patients had diabetes mellitus (one of these was also pregnant), and one patient had asthma (on steroid therapy). The age range for these seven patients was 13 - 17 years. Treatment with local anesthetics helped resolve the adhesion in five patients, and surgical treatment was needed in the remaining two patients. it is concluded that labial adhesion is a severe complication of primary genital herpes in young women. Chronic medical conditions, incorrect diagnosis, and lack of topical treatment may be associated with the development of this complication. Use of topical therapy should be an integral part of the comprehensive treatment for primary genital herpes in female adolescents to alleviate discomfort and prevent urinary retention and labial adhesion.
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