Definition and Overview

A clitoridotomy is a plastic surgery procedure wherein the clitoral hood is either split or removed completely. It is also known as female circumcision and has the same risks and potential complications as male circumcision. It also goes by other names, such as clitoral hoodectomy.

A clitoridotomy is sometimes done in conjunction with other genital modification procedures, most of which are considered as purely cosmetic. Some examples are labiaplasty, a procedure that aims to reduce the labia minora, as well as a vaginoplasty. A clitoridotomy is different from a clitorectomy, which completely removes the clitoral hood and the labia.

Who Should Undergo And Expected Results

Although it is not widely performed, women have a variety of possible reasons for having the procedure done, such as therapeutic/medical, aesthetic, or cultural reasons.

To appreciate the potential benefits of a clitoridotomy, it is important to understand how the clitoris works. The clitoris, which is the most sensitive erogenous part of the female body, is located near the front part of the labia minora, just above the urethral opening. It is considered as the equivalent of the male penis, with the main difference that it does not play a role in urination.

The clitoral glans, considered as the head of the organ, is very small, but it has over 8,000 sensory nerve endings, which are responsible for increased sexual pleasure when the said glans is stimulated. However, the clitoris and the clitoral glans are concealed by the clitoral hood and the labia minora. In some women, the clitoral glans may be completely concealed, whereas in some, it may protrude from the hood in varying degrees. In some cases, the hood itself may also protrude from the labia.

The purpose of clitoridotomy is to reduce the hood to improve the external appearance of the female genital organ or to intentionally expose the clitoral glans to enable direct stimulation. However, some women who do not find direct stimulation pleasurable during sexual intercourse, simply have the clitoral hood split or reduced, instead of removed, so that it will be easier for the glans to become indirectly stimulated.

Some of the functional benefits associated with female circumcision include:

  • Reduced pubic discomfort
  • Improved sexual pleasure
    Since the removal of the clitoral hood leaves the clitoral glans exposed, women who have the procedure done report increased sexual stimulation and pleasure, leading to more pronounced clitoral orgasms.

The aesthetic improvement associated with the procedure, on the other hand, is also known to help improve patients’ self-esteem.

Most women who undergo the procedure are satisfied with the results and the occurrence rating of post-surgical complications is very low. However, some specialists may advise patients to undergo psychological counseling before undergoing the said procedure to help them set the right expectations for the procedure.

The procedure, however, is not supported by all obstetricians and gynecologists. Some medical professionals do not confirm the medical safety and the effectiveness of female circumcision to bring about any therapeutic benefits in the first place.

How Does the Procedure Work?

The specific techniques used in performing a clitoridotomy differ depending on the patient’s specific goals for undergoing the procedure.

One of these techniques is bilateral excision or simply cutting the prepuce tissues that cover the clitoral glans. In this technique, it is important to keep the glans in the midline. Another technique used to perform a clitoridotomy effectively cuts away or excises the folds of the clitoral prepuce tissue. To do so, the surgeon makes incisions that are parallel to the clitoris.

Possible Risks and Complications

A clitoridotomy has a low incidence rating of medical complications. Despite this, the procedure still comes with certain risks, such as:

  • Infection of the surgical wound
  • Scarring
  • Pudendal nerve damage – This complication may cause the patient’s vulva to become either insensitive or overly sensitive.
  • Reduced clitoral sensitivity – It is possible for the clitoral glans to become desensitized after being exposed, rather than enclosed, for a long time.
  • Pain – It is possible for the exposed clitoral glans to become painful or uncomfortable, possibly due to friction from clothing.
  • Dyspareunia – Patients suffering from dyspareunia experience pain when having sexual intercourse.
  • Tissue adhesions – Usually occurring in the form of epidermoid cysts, tissue adhesions may develop from the site of the surgical wound.

    References:

  • Bramwell R, Morland C, Garden AS. Expectations and Experience of Labial Reduction: A Qualitative Study. British Journal of Obstetrics and Gynaecology. 2007. 114(12);1493–1499.

  • Jump up ^ Di Saia JP. An Unusual Staged Labial Rejuvenation. Journal of Sexual Medicine. 2008:5;1263–1267.

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