Introduction: Feminizing surgery is often recommended for patients with congenital adrenal hyperplasia (CAH). Clitoroplasty is a vital step that essentially aims to preserve clitoral sensation and provide a satisfactory cosmetic outcome. This study presents a new, simplified technique for clitoroplasty intended to preserve innervation and the erectile capacity of the clitoris.
Methods: External virilization was assessed by the Prader classification. This new surgical technique for clitoroplasty consists of performing a rectangular excision on the ventral tunica albuginea and a partial excision of the cavernous tissue, without any need to dissect the neurovascular bundle. Mikulicz-type closure was used with the intention of preserving the erectile capacity of the clitoris.
Results: This surgical technique was applied on 25 patients, mean age of 7.02 ± 7.29 years. Four patients were staged Prader II, ten patients were Prader III and eleven had Prader IV scale. The advantages of this technique lie in its simplicity, the fact that it renders dissection of the neurovascular bundle unnecessary, its ability to preserve cavernous blood flow within the clitoris, and finally, the fact that it allows for the possibility of preserving the erectile capacity of the clitoris. Cosmetic outcome is as satisfactory as that achieved with currently used techniques. The outcome of our preliminary experience demonstrates applicability without major complications.
Conclusions: Corporoplasty as a simplified, easily reproducible technique for performing clitoroplasty results in a satisfactory cosmetic outcome, preserving the neurovascular bundle and allowing for the possibility of maintaining the erectile capacity of the clitoris.
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