A New,Hydrodissection with Reverse V-Plasty Technique for the Buried Clitoris Associated with Lichen Sclerosus

Abstract

Abstract

Objective: The aim of this study was to develop a minimally traumatic surgical technique for the buried clitoris associated with lichen sclerosus (LS) and to evaluate the long-term clinical outcome of this surgical technique. Design: The study was designed as a prospective sequential cohort clinical trial in one treatment group. Setting: This clinical trial was conducted at a gynecologic private practice in the United States. Materials and Methods: Materials: Ten (10) women, between ages 15 and 85, were subjected to hydrodissection with a reverse V-plasty procedure for symptomatic buried clitoris associated with skin changes that suggested the presence of LS and histologically documented LS. Methods: The new hydrodissection with reverse V-plasty surgical procedure was performed between October 1994 and December 1999 with follow-up until December 2004. Inclusion criteria were: patients who had buried clitoris associated with characteristic skin lesions for LS and histologically documented LS. Exclusion criteria were applied to any subjects who had previously undergone surgical intervention for clitoral phimosis, clitoral lysis of adhesions, clitoral hoodoplasty, clitoral surgery, or refused a local infiltration as a form of anesthesia. Main Outcome Measures: The primary outcome measure was to evaluate surgical resolution of buried clitoris and esthetic outcomes of the operation. A secondary outcome measure was to apprise reinstitution of clitoral sensation, ability to reach external (clitoral) orgasm, and symptoms' response to the surgical treatment. The endpoints of each subject follow-up were at the completion of 5-year clinical observations. (J GYNECOL SURG 26:41)