Clitoral avulsion successfully repaired with 2-octylcyanoacrylate.

INTRODUCTION: Clitoral piercing is becoming more popular in the general populace, playing an aesthetic as well as likely sexual role. However, potential for injury also impacts future clitoral sexual function, thus highlighting the importance of proper repair.

AIM: To report a 29-year-old woman presented to the emergency department after a clitoral piercing injury. Examination revealed avulsion of most of the clitoral body. After the patient refused expectant and surgical management, reapproximation was performed using 2-octylcyanoacrylate.

METHODS: 2-Octylcyanoacrylate, commonly known as Dermabond(®) (Ethicon Inc., Somerville, NJ, USA), was used to reapproximate the clitoral laceration for this patient. It is a cyanoacrylate tissue adhesive, forming a strong bond between wound edges to allow for normal healing to occur below. Benefits of use are decreased time of repair, water-resistant flexible coating, and no need for suture removal.

RESULTS: The laceration was successfully reapproximated with 2-octylcyanoacrylate. The tissue held together satisfactorily and the patient was discharged to home. She was seen as an outpatient 3 days later, with a moderately tender and swollen clitoris, but with an intact repair and improved pain. A visit 8 weeks later showed a well-healed clitoris, and the patient reported resolution of pain and return of sexual function, with successful orgasms.

CONCLUSIONS: The delicacy of clitoral anatomy and the potential impact of its injury on future sexual function make it an intimidating area of repair for the general physician. The method of repair must be tailored to the injury, patient, and physician; however, 2-octylcyanoacrylate is a viable alternative to traditional surgical or expectant management, offering strength and flexibility while avoiding further trauma with suture.