V7-02: Translabial Corporal Sparing Clitoroplasty
To report our initial results of using a translabial approach to a feminizing genitoplasty
Two patients (ages 16 month old and 16 years old) underwent clitoroplasty using a translabial approach. The 16 month old had a known history of Congenital Adrenal Hyperplasia (CAH) due to 21-hydroxylase deficiency and the 16 year old was an otherwise healthy 46, XX female that was diagnosed with clitoromegaly of unknown etiology. For the clitoroplasty, an interlabial incision between the right labia majora and minora was used to mobilize the corpora, preserve the neurovascular bundles and separate the corporal bodies from the glans. A corporal-sparing dismembered clitoroplasty was then performed with lateral placement of each hemicorpora within the labia minora on each respective side. Due to an enlarged glans, a ventral wedge was removed and internally tacked to the upper corpus spongiosum. Clitoral skin was reduced to recreate a hooded glans.
Pre-operative measurements for the 16 month old CAH female revealed glans width 0.8 cm, stretched phallic length 2 cm, urogenital sinus 1.1 cm. Pre-operative measurements for the 16 year old female revealed a glans width of 12 mm, stretched phallic length of 4 cm, and significant redundancy of the clitoral hood. Intra-operative evaluation revealed excellent cosmesis with a hidden translabial suture line. At postoperative follow-up, both patients and families were satisfied with the aesthetic outcome and reported no paresthesia.
This is the initial experience of a translabial approach to a dismembered corporal clitoroplasty for a feminizing genitoplasty, offering fewer incisions which are concealed in natural skin folds.