Background
Despite the ever increasing popularity of labial and clitoral surgeries, the best practices and long term effects of reconstructive procedures in these regions remain unknown. This is particularly noteworthy since the presentation of nerve related symptoms may be delayed up to a year. Despite the convention that these surgical procedures are low risk, little is known about the best practices that may reduce the postoperative complications as a result of these reconstructive surgeries. We describe a preoperative sensory mapping technique in the context of a symptomatic inclusion cyst in the clitoral region. This technique delineates anatomical and functional regions innervated by the dorsal clitoral nerve while avoiding the vascular watershed area in the midline.
Case
A prototypical case of a patient with a clitoral mass will be discussed with clinical history and surgical approach. Prior to surgical excision, the dorsal clitoral nerve distribution was mapped in order to avoid a surgical incision in this sensual zone.
Conclusions
In our practice, preoperative sensory mapping is a clinically useful planning tool that requires minimal instrumentation and no additional operating time. Sensory mapping allows identification of the functional zone innervated by the dorsal clitoral nerve so that it can be avoided.