Experience with reduction clitoroplasty for clitoral hypertrophy

Area of Science:

• Pediatric Surgery
• Endocrinology
• Genitourinary Surgery

Background:

• Clitoromegaly in females, often due to virilizing congenital adrenal hyperplasia (CAH), presents significant cosmetic and functional challenges.
• Previous management strategies, including total clitorectomy, have been questioned for their long-term impact on patient well-being.

Purpose of the Study:

• To introduce and evaluate a novel reduction clitoroplasty technique for female patients with clitoromegaly secondary to virilizing CAH.
• To assess the cosmetic outcomes and functional results, including sexual gratification, of this surgical approach.

Main Methods:

• A specific reduction clitoroplasty technique was developed and applied to a cohort of patients.
• Surgical outcomes were assessed based on cosmetic appearance and patient-reported functional results, including sexual function.

Main Results:

• The described reduction clitoroplasty technique yielded excellent cosmetic results in all treated patients.
• One patient reported achieving sexual gratification postoperatively without discomfort, indicating preserved or restored function.

Conclusions:

• Reduction clitoroplasty is a viable and effective alternative to total clitorectomy for managing clitoromegaly in virilizing CAH.
• This technique offers improved cosmetic outcomes and the potential for preserved sexual function, challenging prior surgical dogma.