Clitoral reconstructive surgery in patients with vulvar (pre)malignancies: what can we learn from female genital
Guus Veldmate1,2, Renée M F Ebisch1, Karlijn Cornel3
1Department of Obstetrics and Gynaecology, Radboud University Medical Center, Nijmegen, HB 6500, The Netherlands.
Introduction:
Tumors located near the clitoris in vulvar (pre)malignancies represent a distinct clinical category. Achieving tumor-free surgical margins often requires removal of a significant portion of the clitoris, potentially causing profound psychological and sexual impact. Clitoral reconstruction, used in patients with female genital mutilation/cutting (FGM/C), has shown positive outcomes in restoring sexual function and reducing pain.
Objectives:
This scoping review presents an overview of the literature on clitoral reconstruction after treatment for vulvar (pre) malignancies, incorporating insights from FGM/C-related women.
Methods:
A systematic search of PubMed, EMBASE, Web of Science, and the Cochrane Library was conducted up to July 13, 2025. Studies were included if they reported on clitoral reconstructive surgery in patients with vulvar (pre)malignancies or FGM/C.
Results:
Seventeen studies met the inclusion criteria: two addressed clitoral reconstruction in vulvar (pre)malignancies and fifteen in FGM/C, encompassing 3304 women. The Foldès technique was used in 11 of the 15 FGM/C studies. Sexual outcomes were evaluated in 16 studies and psychological well-being in 12. Most reported improved sexual function, body image and reduced genital pain. Complications were reported in 11 studies and included infection, hematoma and delayed healing, with low overall morbidity.
Conclusion:
Evidence on clitoral reconstruction for patients with vulvar (pre)malignant lesions is limited. Data from FGM/C indicate the procedure is feasible and safe and may improve sexual function, body image and quality of life. Adapting FGM/C reconstructive techniques has the potential to improve outcomes for oncological patients, but further research is needed to assess its potential integration into standard care.
