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Step-by-Step Approach for Nerve-sparing Reduction Clitoroplasty
Luiz Gustavo Oliveira Brito1, Arnold Achermann1, Cassio Luis Zanettini Riccetto1
1Department of Obstetrics and Gynecology (Dr. Oliveira Brito); Division of Urology, Department of Surgery (Drs. Achermann and Zanettini Riccetto), School of Medical Sciences, University of Campinas, São Paulo, Brazil.
Study Objective:
To describe a stepwise demonstration of a vaginal approach for nerve-sparing reduction clitoroplasty.
Design:
Video of a case report.
Setting:
Tertiary, academic hospital (Women's Hospital, University of Campinas).
Interventions:
An 18-year-old nulliparous woman consulted with complaints of primary amenorrhea, small development of breasts, and an increase of the clitoris in the last months. A physical examination revealed a 5-cm clitoromegaly, normal but small breasts, and normal vulvar pili. Laboratory examinations showed XY karyotype and increased levels of dehydroepiandrosterone sulfate and follicle stimulating hormone. Surgical planning for reduction clitoroplasty, laparoscopic bilateral gonadectomy, plus removal of the rudimentary uterus was done and performed. The main steps were as follows: The patient was discharged 20 hours after the procedure. The immediate and late postoperative periods occurred with no complications (wound dehiscence, hematoma), and clitoral sensitivity was restored according to the patient's self-report.
Conclusion:
This case shows the importance of nerve-sparing reduction clitoroplasty for reducing the risk of sensitivity loss and/or other complications.
