Diagnosis and treatment of a new type of clitoral hood-labia minora complex hypertrophy: fused lateral clitoral hood and labia minora
10.3760/cma.j.cn114453-20240523-00137
- VernacularTitle:侧方阴蒂包皮-小阴唇融合肥大的诊断与治疗
- Author:
Xinran ZHANG
1
;
Zenan XIA
1
;
Xiao LONG
1
;
Yuanbo KANG
1
;
Guojing CHANG
1
;
Lin ZHU
1
Author Information
1. 中国医学科学院北京协和医学院北京协和医院整形美容外科，北京 100032
- Publication Type:Journal Article
- Keywords:
Genitalia, female;
Surgery, plastic;
Labiaplasty;
Labia minora;
Clitoral hood;
Hypertrophy
- From:
Chinese Journal of Plastic Surgery
2024;40(12):1273-1282
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To identify a new type of hypertrophy of the clitoral hood-labia minora complex(CLC), to propose a classification system for the hypertrophy, and to evaluate surgical techniques and clinical outcomes for fused lateral clitoral hood and labia minora.Methods:A retrospective analysis was conducted on clinical data from patients who underwent labiaplasty surgery at the Department of Plastic and Aesthetic Surgery, Peking Union Medical College Hospital from January 2013 to October 2023. CLC hypertrophy was classified into three types based on whether the CLC was hypertrophic and their free edges fused. Type Ⅰ: isolated labia minora hypertrophy; Type Ⅱ: independent lateral clitoral hood and labia minora hypertrophy; Type Ⅲ: fused type of lateral clitoral hood and labia minora hypertrophy. Type Ⅲ patients were divided into a wedge excision group and a four-step excision group. A satisfaction survey was conducted three months postoperatively using the Goodman female genital aesthetic surgery questionnaire, distributed online to evaluate the surgical outcomes based on vulvar appearance improvement rate, preoperative discomfort improvement rate, postoperative discomfort rate, sexual quality improvement rate, partner satisfaction, and overall satisfaction. Statistical analysis was performed using SPSS 26.0 software, with normal distribution data presented as Mean±SD, intergroup comparisons conducted using t-test, and count data expressed as frequency and(or) percentage with chi-square tests. A P-value < 0.05 was considered statistically significant. Results:A total of 651 female patients (1 243 sides) with CLC hypertrophic deformities were enrolled, aged 18-55 years, with a mean age of 30.7 years. Type Ⅰ consisted of 198 patients with 301 sides(24.22%), Type Ⅱ consisted of 420 patients with 743 sides(59.77%), and Type Ⅲ consisted of 116 patients with 199 sides(16.01%). Some patients had different classifications of CLC on the left and right sides. Among the Type Ⅲ patients, 22 cases were in the wedge resection group and 94 cases in the four-step resection group. Three months postoperatively, 112 patients (195 sides) out of 116 Type Ⅲ patients (199 sides) completed the satisfaction survey. The wedge resection group had 22 patients (44 sides), with an age of (31.6±5.2) years, and the four-step resection group had 90 patients (151 sides), with an age of (32.6±5.5) years. There was no statistically significant difference in age between the two groups ( P>0.05). The four-step resection group had significantly higher vulvar appearance improvement rate [61.11%(55/90) vs. 22.73%(5/22)], preoperative discomfort improvement rate[92.68%(76/82) vs. 58.82%(10/17)], and overall satisfaction [90.00% (81/90) vs. 68.18% (15/22)] compared to the wedge resection group ( P<0.05 for all). The four-step resection group had a sexual quality improvement rate of 21.05%(16/76) and partner satisfaction of 91.14% (72/79), which were not statistically different from the wedge resection group [12.50%(2/16) and 75.00% (12/16)]( P>0.05 for both). The proportion of patients with postoperative discomfort in the four-step resection group was 8.89% (8/90), significantly lower than the 31.82% (7/22) in the wedge resection group ( P< 0.05). There was no statistically significant difference in complication rate between the four-step resection group [2.65% (4/151)] and the wedge resection group [4.55% (2/44)]. Conclusion:CLC hypertrophy can be classified based on clitoral hood and labia minora hypertrophy and fusion type, including isolated labia minora hypertrophy, independent lateral clitoral hood and labia minora hypertrophy, and fused type of lateral clitoral hood and labia minora hypertrophy. The four-step excision method for correcting fused type of lateral clitoral hood and labia minora hypertrophy yields excellent surgical outcomes, low complication rates, and high patient satisfaction.
