Nerve-Sparing Reconstructive Surgery for Cosmetic Repair in Idiopathic Clitoral Glans Enlargement: Clinical Experience with 23 Patients

Öz

OBJECTIVE: In this study, we aim to share our experiences and surgical outcomes using our original clitoral glans reconstruction technique in patients with isolated clitoral hypertrophy MATERIALS and METHODS: A single-center retrospective case series was conducted between January 2018 and November 2024. Twentythree patients, aged 16 to 23, who presented with complaints of excessive clitoral head growth during and immediately after puberty were examined. RESULTS: A total of 23 clitoroplasty procedures were performed and no serious life-threatening complications developed. Viability of all glans was preserved. Two minor complications occurred in two patients: In the first patient, the stitches were opened within the first week after surgery and were quickly re-stitched under local anesthesia. The second complication was that one of our patients developed superficial subcutaneous necrosis in a10% part of the clitoral glans, but 0.5 cc platelet rich plasma was applied to increase the blood circulation of this area and the area healed over time. No significant change was observed in FSFI (Female Sexual Function Index) values before and 6 months after the procedure in sexually active patients. As a result, it was observed that there was no negative impact on sexual function with a low complication rate and successful recovery. CONCLUSION: Clitoral hypertrophy revision surgeries have evolved from amputation surgery to reduction surgery with the development of modern surgical techniques. Further studies with a larger number of patients are required to confirm the data of this study.

Anahtar Kelimeler

• Clitoris/surgery
• clitoris/abnormalities
• reconstructive surgical procedures/methods
• cosmetic techniques
• female sexual function index
• treatment outcome
• adolescent

İdyopatik Mega Boyutlu Klitoral Glansta Sinir Koruyucu Rekonstrüksiyon Tekniğinin Kozmetik Onarımda Kullanımı

Öz

AMAÇ: İzole idyopatik klitoromegali nadir görülen bir durumdur ve cerrahi deneyimler sınırlıdır. Bu çalışmada mega boyutlu klitoral glansta sinir koruyucu rekonstrüksiyon tekniği ile kozmetik onarım sonuçlarımız sunulmaktadır. GEREÇ ve YÖNTEM: 2020–2023 yılları arasında izole idyopatik klitoromegali tanısı alan 23 hasta (16–23 yaş) retrospektif olarak değerlendirildi. Tüm hastalara sinir koruyucu klitoral glans rekonstrüksiyonu uygulandı. Bulgular arasında komplikasyon oranları, glans canlılığı ve FSFI (Kadın Cinsel Fonksiyon İndeksi) ile cinsel fonksiyon değerlendirmesi yer aldı. BULGULAR: Tüm olgularda glans canlılığı korundu. İki minör komplikasyon gözlendi (dikiş açılması ve yüzeyel nekroz). Cinsel aktif hastalarda (n=8) FSFI skorlarında ameliyat öncesi ve 6 ay sonrası arasında anlamlı fark saptanmadı. SONUÇ: Bu yeni sinir koruyucu teknik, düşük komplikasyon oranı ve cinsel fonksiyon korunumu ile etkili kozmetik onarım sağlamaktadır. Bulguların doğrulanması için daha geniş prospektif çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

• Klitoris ameliyatı
• klitoris/anormallikler
• rekonstrüktif cerrahi işlemler/yöntemler
• kadın cinsel fonksiyon indeksi
• tedavi sonucu
• ergen

Kaynakça

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