Clitoral hoodplasty in females with disorders of sex development

K. P. Wolffenbuttel, V. S. Menon, G. M. Grimsby, M. J. ten Kate-Booij, L. A. Baker

Research output: Contribution to journalArticle

Abstract

Introduction: The surgical management of girls with masculinized genitalia is gradually changing towards a more conservative approach. Reports on loss of clitoral sensitivity and related impairment of sexual function in women after feminizing genital surgery in childhood have been pivotal in this evolution. An exposed clitoral glans is occasionally seen at follow-up, and while patients may complain of aesthetics, no clitoral discomfort secondary to glans exposure has been reported. A technique has been developed to reconstruct the clitoral hood and the present study reports the preliminary results. Objectives: To report the novel technique and preliminary results of clitoral hood reconstruction to cover an exposed glans after previous clitoroplasty in patients with congenital adrenal hyperplasia (CAH). Patients and methods: Six female patients (mean age 13, range 4-21 years) with CAH sought medical help for clitoral concerns after previous reduction clitoroplasty. In two of the six patients, the main complaint was clitoral hypersensitivity or even pain. The clitoral glans was completely exposed in all patients, who were subsequently treated with a bi-laminar V-Y clitoral hoodplasty to create a mobile and natural-looking clitoral hood composed of an inner and outer preputial skin layer. Results: Postoperative covering of the glans was complete in five patients, and partial in one. The two patients with pre-operative pain became asymptomatic; all six patients were pleased with the cosmetic postoperative results. Conclusion: Clitoral hoodplasty provides simple, yet effective, relief for women with cosmetic concerns or clitoral discomfort after previous feminizing surgery.Display Omitted. .

Original languageEnglish (US)
JournalJournal of Pediatric Urology
DOIs
StateAccepted/In press - Feb 26 2016

Fingerprint

Disorders of Sex Development
Congenital Adrenal Hyperplasia
Cosmetics
Pain
Genitalia
Esthetics
Hypersensitivity
Skin

Keywords

  • Clitoral hoodplasty
  • Clitoral hypersensitivity
  • Congenital adrenal hyperplasia
  • Disorders of sex development
  • Feminizing surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Urology

Cite this

Clitoral hoodplasty in females with disorders of sex development. / Wolffenbuttel, K. P.; Menon, V. S.; Grimsby, G. M.; ten Kate-Booij, M. J.; Baker, L. A.

In: Journal of Pediatric Urology, 26.02.2016.

Research output: Contribution to journalArticle

Wolffenbuttel, K. P. ; Menon, V. S. ; Grimsby, G. M. ; ten Kate-Booij, M. J. ; Baker, L. A. / Clitoral hoodplasty in females with disorders of sex development. In: Journal of Pediatric Urology. 2016.
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