Neurovascular bundle-sparing ventral clitoroplasty in adult patients: description of the technique and long-term outcome on clitoral functions

Objective: To describe the technique and assess long term effects of neurovascular bundle-sparing adult clitoroplasty on clitoral functions in patients.

Material and methods: A case series study enrolling three patients diagnosed with adult clitoromegaly who underwent neurovascular bundle-sparing ventral clitoroplasty operation. All of the patients were examined at the first, third, sixth, twelfth and twenty-fourth months post-operatively to evaluate clitoral functions.

Results: Three patients diagnosed with adult clitoromegaly, aged 17, 21 and 24 years, were enrolled in the study. The primary complaint of all patients was unpleasant enlarged appearance and hypersensitive clitoris. Mean calculated clitoral index was 143 mm², 150 mm², and 120 mm². Operation time was 90, 140 and 120 minutes, respectively. No major complication occurred during the operation but moderate ecchymosis and edema of the vulva occurred in all patients, lasting up to three weeks. On follow up examination, partial sensorial loss was noted at the first month in one patient, which completely resolved by the third month and beyond. Two patients who were sexually active reported that they were very comfortable with intercourse and cosmetic appearance. No clitoral enlargement or pain were reported by patients through the 24-month follow up period.

Conclusion: Neurovascular bundle-sparing ventral clitoroplasty is a safe and cosmetically acceptable procedure, which effectively preserves the neurovascular bundle and long-term clitoral functions.