Clitoroplasty

Clitoroplasty is the surgical creation of a clitoris in transgender women (as part of sex reassignment surgery), restoration in the case of procedures reversing the damage caused by female genital cutting, or surgery to change clitoral size for women and girls with congenital adrenal hyperplasia.[1]

Clitoroplasty
Specialtygynecology

Clitoroplasty in sex reassignment surgery

As part of reassignment surgery for trans women, there are several ways to create a clitoris from existing tissue. The most common method in practice is to separate the penile glans from the paired erectile tissues, and reduce in size to simulate a clitoris.

The success rate for the creation of a clitoris for trans women greatly varies. The most common cause of failure is the necrosis of the tissue from lack of blood supply. The greatest non-lethal health risk is damage to the pudendal nerves that greatly reduces the chances and intensity of orgasms when severed.

Most trans women's bodies readily accept the relocation of glans penile tissue in the area of a woman's clitoris. Dr Suporn Watanyusakul uses a modified technique that preserves some erectile tissue to simulate clitoral engorgement and a small amount of foreskin to act as a clitoral hood.

An alternative technique involved the use of urethral spongiform as a clitoral mound. This allowed for better simulation of female sexual response at the cost of the clitoris being not as sensate as one derived from the glans penis. Urine leakage was a notable complication with this technique.[2]

Older genital reassignment techniques made no attempt at the creation of a clitoris at all. The glans of the penis was sutured in the most distal (inner) area of the neovagina to simulate a cervix. The late Stanley Biber preferred this method.

References
  1. Clitoroplasty in Intersex: a New Technique 1998 British Journal of Urology, 1981 original publication
  2. Fang, Rong-Hwang; Chen, Cheng-Feng; Ma, Shiuh "A New Method for Clitoroplasty in Male-to-Female Sex Reassignment Surgery", Plastic and Reconstructive Surgery, April 1992, volume 89, issue 4
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