Clitoral reconstructive surgery for patients with vulvar carcinoma
Mieke Ten Eikelder1, Guus Veldmate2, Felix Pettai1
1Department of Obstetrics and Gynaecology, Radboud University Medical Center, 6500 HB Nijmegen, the Netherlands.
Gynecologic Oncology
|July 21, 2026
Summary
Vulvar cancer surgery can now include clitoral reconstruction, restoring anatomy and function. This technique preserves neurovascular integrity and may significantly reduce psychosexual distress for patients.
Area of Science:
- Oncology
- Plastic Surgery
- Gynecology
Background:
- Vulvar cancer often requires clitoral excision, causing significant psychosexual and functional deficits.
- Current vulvar reconstruction methods rarely address clitoral restoration.
- A novel technique adapts the Foldès method for anatomical and functional clitoral reconstruction.
Purpose of the Study:
- To provide an anatomical overview of the clitoris.
- To describe the surgical technique for clitoral reconstruction post-oncological excision.
- To report postoperative outcomes, including sensation and complications.
Main Methods:
- Anatomical review and step-by-step surgical technique description.
- Case series of 18 vulvar cancer patients undergoing clitoral reconstruction.
- Detailed reporting of patient characteristics, surgical details, and postoperative outcomes.
Main Results:
- A combined approach involving margin assessment, ligament release, mucosal grafting, and neohood formation preserves neurovascular integrity.
- 88.9% of patients achieved clitoral orgasm post-reconstruction.
- Clitoral reconstruction added approximately 15 minutes to surgery with a 11.1% complication rate.
Conclusions:
- Clitoral reconstruction is technically feasible in vulvar cancer surgery.
- The procedure preserves anatomical landmarks and has a low complication rate.
- Reconstruction may mitigate psychosexual morbidity without compromising oncological safety.
