Wee Yan Chia
Paediatric Surgeon with a special interest In reconstructive urology. Over the past 25 years, have extensive experience in the management of DIsorder of Sex Development and exstrophy reconstruction
Phone: +61416054898
Phone: +61416054898
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allows for future total reversal to male and report on its initial result.
Material and methods: A potentially reversible operation for feminizing clitoroplasty that preserves
all available tissue was performed in three patients: two girls with congenital adrenal
hyperplasia and a ‘46XY male’ with androgen insensitivity. The phallus was disassembled into
its individual components of the phallic skin, left and right corpus cavernosum, dorsal neurovascular
bundle with the dorsal portion of the glans, and ‘urethral plateecorpus spongiosum
complex’ with the ventral portion of the glans attached. Each corpus cavernosum was folded
upon itself and then hidden in the subcutaneous fat to increase the size of the labia majora.
The partially divided urethral plate was used to form the inner part of the labia minora and the
clitoral hood. The phallic skin was partially divided and used to form the outer part of the labia
minora. This operation allowed feminizing clitoroplasty to be completed without significant
excision of any tissue, including the corpora cavernosa.
Results: The operation was completed successfully in all three patients, two with concomitant
inverted ‘V’ flap vaginoplasty. One patient had postoperative haematoma. All three have a cosmetically
acceptable ‘female look’ to the satisfaction of themselves and their parents.
Conclusion: This preliminary result suggests that a cosmetically acceptable feminizing clitoroplasty
can be performed with preservation of all phallic tissue, in particular the corpora cavernosa.
This potentially reversible operation may be advantageous when feminizing
genitoplasty has to be performed in a young child with disorders of sex development.
allows for future total reversal to male and report on its initial result.
Material and methods: A potentially reversible operation for feminizing clitoroplasty that preserves
all available tissue was performed in three patients: two girls with congenital adrenal
hyperplasia and a ‘46XY male’ with androgen insensitivity. The phallus was disassembled into
its individual components of the phallic skin, left and right corpus cavernosum, dorsal neurovascular
bundle with the dorsal portion of the glans, and ‘urethral plateecorpus spongiosum
complex’ with the ventral portion of the glans attached. Each corpus cavernosum was folded
upon itself and then hidden in the subcutaneous fat to increase the size of the labia majora.
The partially divided urethral plate was used to form the inner part of the labia minora and the
clitoral hood. The phallic skin was partially divided and used to form the outer part of the labia
minora. This operation allowed feminizing clitoroplasty to be completed without significant
excision of any tissue, including the corpora cavernosa.
Results: The operation was completed successfully in all three patients, two with concomitant
inverted ‘V’ flap vaginoplasty. One patient had postoperative haematoma. All three have a cosmetically
acceptable ‘female look’ to the satisfaction of themselves and their parents.
Conclusion: This preliminary result suggests that a cosmetically acceptable feminizing clitoroplasty
can be performed with preservation of all phallic tissue, in particular the corpora cavernosa.
This potentially reversible operation may be advantageous when feminizing
genitoplasty has to be performed in a young child with disorders of sex development.