clitorectomy

We propose a method in which vulvar reconstruction could be accomplished at the time of vluvectomy. A full-thickness pedicle flap is rotated from the vaginal vault to the area of excision, providing excellent coverage without subsequent contracture, and obviating the need for clitorectomy. This technique may also aid in palliating the psychological trauma induced by genital disfigurement.

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A case of true hermaphroditism, in a 4-year-old, legally female, is reported. The external genitalia showed clitorism and labial agglutinate, and her karyotype from peripheral lymphocytoculture was 46,XX. She received gonadectomy at both sides, clitorectomy and plasty of vaginal orifice. Histopathological examination showed that both gonads were ovotestis.

A 1-year-old infant with von Recklinghausen's neurofibromatosis was seen because of increasing clitoral enlargement over a 7-month period. The mother, who also had neurofibromatosis, was treated 2 years beforehand for an acoustic neuroma. The child was treated by radical clitorectomy. Pathologic examination revealed malignant schwannoma, a tumor not previously described in this site. Vincristine, dactinomycin, and cyclophosphamide chemotherapy was given for 2 years to prevent local recurrence and metastatic spread...

Authors present a critical study and the results on clitoroplasty in 71 patients with ambiguous genitalia. In 3 patients were performed a clitorectomy and a clitoroplasty was performed in 58 according Pellerin's technique. Ten clitoroplasties according Spence-Allen technique were also performed.

We report an unusual case of clitoral hypertrophy due to neurofibromatosis of the external genitalia. Because of no definite skin signs or other nervous or osseous symptoms such as are commonly found in neurofibromatosis, the patient was at first suspected of being a case of hermaphroditism. Finally, the disorder was properly diagnosed after laparotomy followed by clitorectomy. This patient seems to be the 12th case of clitoral neurofibroma reported in the English literature.

Proper gender assignment to a neonate born with ambiguous genitalia is a social emergency of the newborn period. Once an appropriate sex assignment has been made, the next critical step is performance, if needed, of a reconstructive procedure in a timely fashion. In an attempt to evaluate our experience with this unique group of patients, we have retrospectively reviewed the course of 69 children with ambiguous genitalia managed surgically at this institution between 1974 and 1989. This series consists of 32 genotypic females with congenital adrenal hyperplasia (CAH), 10 children with mixed gonadal dysgenesis (MGD), 10 male pseudohermaphrodites, 3 true hermaphrodites, 8 genotypic females with urogenital sinus anomalies (UGS), and 6 genotypic males with bilateral undescended testes and penoscrotal hypospadius...

A technique for reduction clitoroplasty has been devised which provides an excellent cosmetic appearance for female patients with clitoromegaly due to virilizing CAH. Contrary to previous views, total clitorectomy should rarely, if ever, be considered as an initial method of management of children with clitoral hypertrophy. One of the 4 patients who has undergone reduction clitoroplasty using the described technique has achieved sexual gratification on several occasions postoperatively without discomfort.