Objective(purpose)
In male-to-female gender affirming surgery, the neo-clitoris plays a significant role in external genital reconstruction. Traditionally, we apply the “Folding and fixation of pedicle” method to construct neo-clitoris, which gained satisfied results. But a few patients were disappointed with the wide clitoris body. Thus, we designed a technique to achieve aesthetic contour of neo-clitoris.
Material and Methods
Regarding the reconstruction of neo-clitoris, a part of the tunica albuginea stuck directly to the dorsal neurovascular bundle was preserved. The pedicle was folded, and the proximal half was fixed towards the pubic symphesis. Therefore, the tunica albuginea of the distal half was in inferior aspect. The trimmed tunica albuginea was tubed inwardly and approximated with sutures. The neo-clitoral glans which rests in distal end of the pedicle was left as a free end, no additional fixations to pubic bone was applied. This technique makes neo-clitoral body projected and slightly movable, which resembles external genitalia of cis-woman.

Results
Fourteen patients underwent this surgery since March 2021. The average follow-up time was 3 months. All patients were satisfied with the natural contour. There was no adverse effect. Long-term follow-up is lacking at present.
Conclusions
This tubing technique prevents widening of the neo-clitoral body and makes it movable, which achieves a more natural looking of the clitoris. All patients are satisfied with the aesthetic result.

Download