Step-by-Step Approach for Nerve-sparing Reduction Clitoroplasty

Area of Science:

• Reproductive Medicine
• Surgical Techniques
• Genetics

Background:

• Clitoromegaly in individuals with XY karyotype can present with primary amenorrhea and elevated androgens.
• Surgical intervention, including reduction clitoroplasty, may be necessary for cosmetic and functional reasons.

Observation:

• A case report details a vaginal approach for nerve-sparing reduction clitoroplasty in an 18-year-old nulliparous woman with XY karyotype, primary amenorrhea, and significant clitoromegaly.
• The patient also underwent laparoscopic bilateral gonadectomy and removal of a rudimentary uterus.
• Postoperative recovery was uneventful, with no immediate or late complications reported.

Findings:

• The described surgical technique successfully reduced clitoral size while preserving nerve function.
• The patient self-reported restored clitoral sensitivity post-procedure.
• This approach minimizes the risk of complications such as loss of sensitivity.

Implications:

• Demonstrates a viable surgical option for managing clitoromegaly in specific genetic conditions.
• Highlights the importance of nerve-sparing techniques in preserving sexual function and patient satisfaction.
• Provides a valuable educational resource for surgeons performing reduction clitoroplasty.