Labial Adhesions

A patient 4 yrs of age with recurrent labial adhesion. Had been treated multiple times (read 5-6) with topical estrogen. What should I do next. Have already taken gynecologist, ped surgery, another pediatrician opinion but was again and again prescribed topical estrogen. Is continuing the same treatment. I was asking whether I should go with adjunctive therapy with steroids. Like Lupiderm M, Or Statum B. Any workup needed?

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Surgical treatment

Estradiol 0.01

Local application for estrogen U can add steroids cream for local application But no need for surgery

Surgical intervention

Yes now...surgery is needed

Estrogen cream application if not controlled then surgical management

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