Clitoroplasty in Congenital Adrenal Hyperplasia: Description of Technique

Abstract

Female patients with congenital adrenal hyperplasia (CAH) may develop masculinized genitalia in utero upon exposure to excess androgen. This masculinization may be characterized by hyperpigmented or fused labioscrotal tissue, enlarged labia majora, a urogenital sinus, and clitoromegaly. Clitoromegaly may vary, ranging from an ordinary clitoris to a significantly enlarged clitoris similar to a near-normal penis, with any degree of intermediate variation. Surgical management of clitoromegaly may ensure adequate sexual function, promote consistent female gender identity development, and provide a typical clitoris aesthetic. Patients and families considering clitoral surgery should make every effort to understand the options, risks, and benefits of this surgery. If surgery is being considered, it should only be performed in centers with significant experience.