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Reduction Clitoroplasty by Ventral Approach: Technical Refinement.

Uddhav A Patil1,2, Paddmaja U Patil3, Manasi S Devdikar4

  • 1Department of Plastic Surgery, D. Y. Patil Medical College and Hospital, Kolhapur, Maharashtra 416006 India.

Journal of Obstetrics and Gynaecology of India
|April 9, 2019
PubMed
Summary
This summary is machine-generated.

Clitoral reduction surgery using a ventral approach preserves sensation and improves aesthetics in women with clitoromegaly. This refined technique offers satisfactory outcomes for congenital adrenal hyperplasia patients.

Keywords:
Ambiguous genitaliaClitoral hypertrophyClitoromegalyNerve sparing ventral clitoroplastyPhalloplastyReduction clitoroplasty

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Area of Science:

  • Genitourinary surgery
  • Female sexual reconstructive surgery
  • Endocrinology

Background:

  • Aesthetic concerns regarding vulvar appearance are increasingly common.
  • Clitoromegaly, often linked to congenital adrenal hyperplasia (CAH), can cause psychological distress and sexual dysfunction.
  • Surgical interventions for clitoromegaly aim to improve both function and appearance.

Purpose of the Study:

  • To describe a refined nerve-sparing clitoroplasty technique using a ventral approach for clitoral reduction.
  • To highlight the importance of preserving glans clitoris sensation and achieving optimal aesthetic results.
  • To evaluate the efficacy of this approach in managing clitoromegaly due to CAH.

Main Methods:

  • A case study of an adult patient with late-onset CAH and clitoromegaly.
  • Nerve-sparing reduction clitoroplasty performed via a ventral approach under moderate magnification.
  • Detailed preoperative anatomic evaluation and stepwise technical refinements were employed.

Main Results:

  • The patient achieved normal-appearing genitalia with a reduced clitoris.
  • Excellent preservation of sensation to light touch in the glans clitoris was noted.
  • The surgical outcome was deemed satisfactory, particularly regarding aesthetics.

Conclusions:

  • Preservation of clitoral sensation is critical in clitoral reduction surgery.
  • A ventral approach with refined techniques and moderate magnification is safe and effective.
  • Preoperative planning is essential for optimizing aesthetic outcomes in female genital surgery.