Clitoral reduction through resection of the corpora cavernosa with preservation of dorsal and ventral innervation
Makiyan Z.N.
Relevance: Over 90% of newborns with disorders of sex differentiation are assigned female at birth and require feminizing genitoplasty to correct external genitalia. Feminizing plastic surgery of the external genitalia is indicated in cases of pronounced virilization in adulthood. While clinical guidelines address the management of intersex conditions, surgical correction techniques have not been standardized in gynecological practices.
Objective: To optimize the surgical management of clitoromegaly in various forms of female virilization.
Materials and methods: Five patient groups were categorized based on their genome, gonadal morphology, and phenotype (including individuals with a male karyotype) who exhibited similar virilization features on the Prader scale. Surgical correction was performed in 33 female patients presenting with marked virilization of the external genitalia (Prader stages III–V).
Results: Clitoral reduction was achieved by resecting the corpora cavernosa while preserving the dorsal and ventral neurovascular bundles, thereby reducing clitoral size while maintaining erogenous sensitivity. During surgical treatment, the author studied the anatomical features of the genital tubercle, examined embryonic micro-preparations from the Carnegie collection, and compared the findings with current anatomical concepts.
Conclusion: Clitoral reduction via resection of the corpora cavernosa, with preservation of dorsal and ventral innervation, allowed maintenance of erogenous sensitivity. Postoperative evaluations demonstrated satisfactory cosmetic outcomes, a feminine appearance of the genitalia, and preservation of erogenous sensitivity in the clitoris, vaginal vestibule, and labia minora.
Conflicts of interest: The author has no conflicts of interest to declare.
Funding: There was no funding for this study.
Patient Consent for Publication: All patients provided informed consent for the publication of their data.
Author Data Sharing Statement: The data supporting the findings of this study are available upon request from the author.
For citation: Makiyan Z.N. Clitoral reduction through resection of the corpora cavernosa
with preservation of dorsal and ventral innervation.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2026; (2): 86-91 (in Russian)
https://dx.doi.org/10.18565/aig.2025.201
Keywords
virilization
clitoral reduction
genital tubercle
disorder of sex differentiation
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Received 23.07.2025
Accepted 26.11.2025
About the Authors
Zograb N. Makiyan, Dr. Med. Sci., Leading Researcher at the Department of Operative Gynecology, Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia, 4, Oparin str., Moscow, 117997, Russia, makiyan@mail.ru, https://orcid.org/0000-0002-0463-1913Similar Articles
