Anatomical study of the clitoris and its implications on female genital mutilation and surgical repair

Blayney, Fanny; Camuzard, Olivier; Klein, Arthur; Perchenet, Anne-Sophie; Bertrand, B.; Philandrianos, C.; Massin, Valentin; Lopez, Maxime Abellan; Casanova, Dominique

doi:10.1016/j.bjps.2021.05.034

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…In total, clitoral structures from 2432 biological females ( n ) aged 18–84 years‐old were recorded (Table 1). Four studies (Suh et al, 2003 ( n = 18); Abdulcadir et al, 2016 ( n = 15); Vaccaro et al, 2014 ( n = 20); Bowen et al, 2022 ( n = 22) were performed through MRI ( n = 87), two studies (Buisson et al, 2008 ( n = 5); Aydin et al, 2021 ( n = 108) were performed using US ( n = 113), four studies (O'Connell et al, 1998 ( n = 10); Jackson et al, 2019 ( n = 27); Kelling et al, 2020 ( n = 10); Blayney et al, 2021 ( n = 7) measured cadaveric clitoral structures ( n = 54), whereas 11 studies (Lloyd et al, 2005 ( n = 50); Basaran et al, 2008 ( n = 100); Mendiola et al, 2021 ( n = 100); Cao et al, 2015 ( n = 319); Köşüş et al, 2016 ( n = 35); Kreklau et al, 2018 ( n = 557); Gyftopoulos et al, 2019 ( n = 56); Chinkangsadan et al, 2020 ( n = 155); Ellibeş Kaya et al, 2020 ( n = 208); Agrawal et al, 2021 ( n = 400); Ekmez & Ekmez, 2021 ( n = 210) measured clitoral structures in living patients ( n = 2190). No significant difference ( p > 0.05) was observed between each clitoral structure and the experimental modality utilized.…”

Section: Resultsmentioning

confidence: 99%

Beyond the tip of the iceberg: A meta‐analysis of the anatomy of the clitoris

Longhurst,

Beni,

Jeong

et al. 2023

Clinical Anatomy

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An understanding of ranges in clitoral anatomy is important for clinicians caring for patients including those who have had female genital mutilation, women seeking genital cosmetic surgery, or trans women seeking reconstructive surgery. The aim of this meta‐analysis is to investigate the ranges in clitoral measurements within the literature. A meta‐analysis was performed on Ovid Medline and Embase databases following the PRISMA protocol. Measurements of clitoral structures from magnetic imaging resonance, ultrasound, cadaveric, and living women were extracted and analyzed. Twenty‐one studies met the inclusion criteria. The range in addition to the average length and width of the glans (6.40 mm; 5.14 mm), body (25.46 mm; 9.00 mm), crura (52.41 mm; 8.71 mm), bulb (52.00 mm; 10.33 mm), and prepuce (23.19 mm) was calculated. Furthermore, the range and average distance from the clitoris to the external urethral meatus (22.27 mm), vagina (43.14 mm), and anus (76.30 mm) was documented. All erectile and non‐erectile structures of the clitoris present with substantial range. It is imperative to expand the literature on clitoral measurements and disseminate the new results to healthcare professionals and the public to reduce the sense of inadequacy and the chances of iatrogenic damage during surgery.

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Section: Resultsmentioning

confidence: 99%

Beyond the tip of the iceberg: A meta‐analysis of the anatomy of the clitoris

Longhurst,

Beni,

Jeong

et al. 2023

Clinical Anatomy

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“…1A-B). According to Blayney et al, this maneuver allows an anteroposterior mobilization of up to 3 cm without compromising the neurovascular bundle 29,30 (Fig. 1C).…”

Section: Methodsmentioning

confidence: 99%

Sensitivity after Clitoral Reconstruction in Patients with Female Genital Mutilation

von Fritschen,

Strunz,

Scherer

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: In the past decades, reconstructive choices after female genital mutilation extended beyond de-infibulation and scar release. The current trend to expand techniques addressing sexual and aesthetic aspects by reconstructing the clitoris and prepuce, and dissecting the clitoral nerves raises concern, as there is a paucity of evidence on the functional outcomes and suspected iatrogenic lacerations. Methods: A total of 128 female genital mutilation patients were included in the study. To evaluate clitoral sensitivity after elevation, the Semmes-Weinstein-monofilament test was performed before and after genital reconstruction. Results: Preoperatively, patients with a visually intact clitoris showed significantly better sensitivity compared with patients with a mutilated clitoris or infibulation (P < 0.0001). Surgery was performed in 84 patients. After clitoral reconstruction (CR), 70 of 73 patients were able to perceive 2.83 monofilaments (95.9%), whereas three perceived 3.61. Patients with a visually intact clitoris served as control, and 95.0% perceived 2.83 monofilaments. We showed a significant improvement of clitoral sensitivity (P = 0.0020) in the subgroup consisting of patients with a mutilated clitoris in whom the test was performed before and after reconstruction. Conclusions: Clitoral sensitivity improves significantly after CR. Seventy of 73 patients attained the same sensitivity as unharmed women. No patient showed a decreased sensitivity compared with their preoperative findings. Therefore, our study supports the argument that CR offers sufficient improvement of objective clitoral sensitivity without additionally addressing clitoral nerves.

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“…For example, this average length has been recorded as greater than 4.0 cm in a cadaveric (4.5 cm) (Kelling et al, 2020) and magnetic resonance imaging study (4.3 cm) (Vaccaro et al, 2014). Furthermore, two additional cadaveric studies report average measurements toward the higher end of the range provided in Sobotta Anatomy Textbook (Waschke et al, 2019), as 3.7 cm (Jackson et al, 2019) and 3.9 cm (Blayney et al, 2021), respectively.…”

Section: The Importance Of Diverse and Accurate Descriptions Of Genit...mentioning

confidence: 98%

The importance of diverse and accurate descriptions of genital anatomy in textbooks

Beni

Fisher

Longhurst

2022

Anatomical Sciences Ed

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Anatomical study of the clitoris and its implications on female genital mutilation and surgical repair

Cited by 3 publications

References 28 publications

Beyond the tip of the iceberg: A meta‐analysis of the anatomy of the clitoris

Beyond the tip of the iceberg: A meta‐analysis of the anatomy of the clitoris

Sensitivity after Clitoral Reconstruction in Patients with Female Genital Mutilation

The importance of diverse and accurate descriptions of genital anatomy in textbooks

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