Tissue-preserving feminizing clitoroplasty: a preliminary report.

Area of Science:

• Pediatric Surgery
• Genitourinary Surgery
• Endocrinology

Background:

• Disorders of sex development (DSD) often require complex surgical interventions.
• Feminizing genitoplasty aims to create female-appearing genitalia.
• Preservation of erectile and sensitive tissues is crucial for future sexual function and patient satisfaction.

Purpose of the Study:

• To describe a novel, tissue-preserving feminizing clitoroplasty technique.
• To evaluate the potential for future reversal to a male anatomy.
• To report initial outcomes of this reconstructive approach.

Main Methods:

• A reconstructive technique disassembling the phallus into its components was performed in three patients with DSD.
• All available tissues, including the corpora cavernosa, were preserved.
• Components were utilized to construct labia majora, labia minora, and clitoral hood.

Main Results:

• The procedure was successfully completed in all three patients.
• Cosmetically acceptable female genitalia were achieved, meeting patient and parental satisfaction.
• One patient experienced a postoperative hematoma.

Conclusions:

• This tissue-preserving feminizing clitoroplasty offers a cosmetically acceptable outcome.
• Preservation of all phallic tissue, notably the corpora cavernosa, allows for potential future reversal.
• This technique may be advantageous for feminizing genitoplasty in young children with DSD.