title: Labial adhesion and bacteriuria.
abstract: OBJECTIVE
  The purpose of this study is to evaluate the clinical presentation, laboratory findings, and response to treatment in girls with labial adhesion younger than 23 months.
  
  
  METHODS
  A retrospective chart review of all girls younger than 23 months with the diagnosis of labial adhesion was referred to Dr Sheikh children's clinic in Mashhad in northeast Iran between 1998 and 2013.
  
  
  RESULTS
  Sixty-three patients were diagnosed with labial adhesion during the review period. Most patients were diagnosed by physicians during the physical examination or during the evaluation for their voiding problems. The most prevalent symptom among patients was dysuria and restlessness while voiding. Twenty-one (33.3%) patients had a history of urinary tract infection. 17 (26.9%) patients had sterile pyuria and 69.8% showed presence of bacteria in their urine samples.
  
  
  CONCLUSIONS
  Physicians may frequently encounter pre-pubertal girls whose urinalysis may show sterile pyuria or presence of bacteria with colony counts <105 in the absence of urinary tract infection symptoms. In these cases, labial adhesion should always be suspected and genital examination should be performed.
authors.affiliation: Department of Pediatrics, Mashhad University of Medical Sciences School of Medicine, Mashhad, Iran.
authors.forename: Anoush
authors.initials: A
authors.lastname: Azarfar
authors.affiliation: Department of Pediatrics, Mashhad University of Medical Sciences School of Medicine, Mashhad, Iran.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Ravanshad
authors.affiliation: Department of Pediatrics, Mashhad University of Medical Sciences School of Medicine, Mashhad, Iran.
authors.forename: Sepideh
authors.initials: S
authors.lastname: Bagheri
authors.affiliation: Department of Pediatrics, Mashhad University of Medical Sciences School of Medicine, Mashhad, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Esmaeeli
authors.affiliation: Department of Pediatrics, Mashhad University of Medical Sciences School of Medicine, Mashhad, Iran.
authors.forename: Mahmood Malek
authors.initials: MM
authors.lastname: Nejad
keywords: Labial adhesion; bacteriuria; topical estrogen; urinary tract infection