Clitoral plastic

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Normal development of the clitoris

Anatomy of the clitoris

Clitoroplasty (engl. Clitoroplasty ) is a surgical procedure by which a normal shape of the clitoris is to be manufactured without affecting sexual function. It is used in children with intersex developmental disorders such as pseudo-hermaphroditism or clitoromegaly , if necessary together with corrections of the labia in order to form an adequate vagina .

In simple terms, the penis is reduced in size and reshaped, the tissue of the glans and possibly the erectile tissue shifted to the position of the normal clitoris. For the later function it is essential that the nerve supply (so-called dorsal neurovascular bundle ) is not damaged. The published success rates are different because neither the surgical technique nor the methods for controlling intact sexual function have been standardized. Knowledge of the neurophysiological processes involved in female sexuality is still insufficient. An operation as early as possible in early childhood (in the first two years of life) seems to be more favorable as a result, since sexual identity develops after this time. However, operations on adult patients are also possible. In the case of acquired (hormone-related) developmental disorders, the cause must also be corrected.

According to Fowler's method, which has been widespread since the 1970s, the corpora cavernosa is first tied off and surgically reduced in size from the front (this protects the nerves lying behind). The glans is also reduced in size and shaped into a cone. The clitoris is now folded like a hairpin with the wound surfaces on top of one another and fixed with sutures so that the glans comes to lie on the surface of the crura bifurcation. It should correspond in shape and size to a normal clitoris and should not be visible when swollen due to sexual arousal. If necessary, small labia can be formed from the excess skin of the penis .

Postoperative dangers are bleeding, necrosis in the operating area and strictures (narrowing) of the urethra. Later on, the altered clitoris can hurt when sexually aroused. A possible undesirable long-term effect is a sensory disorder (numbness) of the clitoral surface with a disruption of the ability to orgasm .

In individual cases, clitoral plasty has also been used in women who suffer from genital mutilation .

literature

• Rudolph Hohenfellner , John Fitzpatrick, Jack McAninch: Advanced Urologic Surgery . John Wiley & Sons, April 15, 2008, ISBN 978-0-470-75513-6 , pp. 338-42 (accessed August 27, 2013).
• WL Lean, JM Hutson, AV Deshpande, S. Grover: Clitoroplasty: past, present and future. Pediatric Surgery International, online February 28, 2007. doi : 10.1007 / s00383-007-1893-y
• L. Liu, J. Fan, C. Gan, J. Tian: Staged reconstruction of the labia minora and reduction clitoroplasty for female pseudohermaphroditism. (Case report) Aesthetic Plastic Surgery, online April 23, 2010. doi : 10.1007 / s00266-010-9501-2

Individual evidence

1. ↑ John M. Hutson, Garry L. Warne, Sonia R. Grover: Disorders of Sex Development: An Integrated Approach to Management . Springer, March 28, 2012, ISBN 978-3-642-22963-3 , pp. 174-179 (accessed August 28, 2013).
2. ^ Howard B. Goldman: Complications of Female Incontinence and Pelvic Reconstructive Surgery . Springer, August 9, 2012, ISBN 978-1-61779-924-2 , pp. 206–7 (accessed August 28, 2013).
3. ↑ The Kindest Cut. ( Memento of the original from January 16, 2013 in the Internet Archive ) Info: The archive link was inserted automatically and has not yet been checked. Please check the original and archive link according to the instructions and then remove this notice. Newsweek / TheDailyBeast October 19, 2009 
4. ↑ Surgery offers new hope for victims of female genital gutilation. Huffington Post March 18, 2010