5yr old w/ significant vaginal adhesion, but no problem w/ urination, what dose of topical estrogen to start & does this need referral to pedi uro?

Labial adhesion: The labia minora sometimes stick together like the wet pages of a book. If gentile traction will not separate them, many practitioners prescribe Premarin (conjugated estrogens) cream. Twice daily application right at the line of adhesion with a q-tip will often soften the adhesion within a few days to 2 wks. Sometimes a little at a time can be opened.I work from the top down.I haven't sent one to uro in >3 decades.