Anatomical studies of the human clitoris

Area of Science:

• Anatomy
• Embryology
• Surgical Science

Background:

• Fetal testosterone exposure can cause external genitalia masculinization.
• Surgical correction of the clitoris necessitates a thorough understanding of normal female anatomy.

Purpose of the Study:

• To describe the anatomical features of the human fetal clitoris.
• To provide anatomical data for guiding reduction clitoroplasty techniques.

Main Methods:

• Serial sectioning and staining of 14 human fetal clitoral specimens (8-24 weeks gestation).
• 3D reconstruction of nerves, corporeal bodies, and glans clitoris using imaging software.
• Comparison with postnatal surgical specimens from feminizing genitoplasty.

Main Results:

• The fetal clitoris has two corporeal bodies with a midline septum and ultrastructure similar to the male penis.
• Extensive nerve bundles surround the corporeal bodies, with a nerve-free zone at the 12 o'clock position.
• Glans innervation is densest dorsally, with lower density ventrally near the glans septum.

Conclusions:

• Detailed knowledge of clitoral anatomy, particularly nerve distribution, is essential for successful surgical reconstruction.
• Preservation of the extensive dorsal nerve network is critical during reduction clitoroplasty.
• The analogous structure of corporeal bodies to the penis should be considered during extensive resection.