Step-by-Step Approach for Nerve-sparing Reduction Clitoroplasty.

STUDY

OBJECTIVE

To describe a stepwise demonstration of a vaginal approach for nerve-sparing reduction clitoroplasty.

DESIGN

Video of a case report.

SETTING

Tertiary, academic hospital (Women's Hospital, University of Campinas).

INTERVENTIONS: An 18-year-old nulliparous woman consulted with complaints of primary amenorrhea, small development of breasts, and an increase of the clitoris in the last months. A physical examination revealed a 5-cm clitoromegaly, normal but small breasts, and normal vulvar pili. Laboratory examinations showed XY karyotype and increased levels of dehydroepiandrosterone sulfate and follicle stimulating hormone. Surgical planning for reduction clitoroplasty, laparoscopic bilateral gonadectomy, plus removal of the rudimentary uterus was done and performed. The main steps were as follows: The patient was discharged 20 hours after the procedure. The immediate and late postoperative periods occurred with no complications (wound dehiscence, hematoma), and clitoral sensitivity was restored according to the patient's self-report.

CONCLUSION

This case shows the importance of nerve-sparing reduction clitoroplasty for reducing the risk of sensitivity loss and/or other complications.