Sculpturing the neoclitoris in vaginoplasty for male-to-female transsexuals.

One of the goals of vaginoplasty for transsexuals is the construction of an aesthetically appealing female perineum. Cosmetic considerations imply the creation of a clitoris-like structure ventral to the urethral orifice. A review of the scarce references on neoclitoroplasty in the literature on vaginoplasty is given. In our hospital, the neoclitoris is usually sculptured to its final appearance during the actual vaginoplasty, employing a free composite graft of the tip of the penile glans to cover the shortened dorsal neurovascular bundle. From the review of the literature and from our experience one may conclude that our technique presents hardly any complications and leads to acceptable results, both functionally and cosmetically. We consider transpositioning of the glans on its long dorsal neurovascular pedicle a technique with too high a risk.