New surgical technique reconstructs the clitoris after treatment for vulvar cancer

For women who undergo vulvar cancer treatment, a new surgical technique has been developed to reconstruct the clitoris for the first time. This comes 40 years after the first penile reconstruction surgery. Gynecologic oncologist Mieke ten Eikelder from Radboudumc explains that while surgery for vulvar cancer can save lives, it can also significantly impact a woman's sexual function and quality of life.

Traditionally, after tumor removal, the wound was simply closed, leaving the clitoris hidden beneath a layer of skin with minimal attention to quality of life or orgasm potential.

In response to this, plastic surgeon Tim Nijhuis collaborated with Ten Eikelder to create a new surgical approach. Once the tumor is removed, the nerve bundles are released and repositioned to construct a new clitoral tip. The tip is then covered with a small graft made of buccal mucosa, which closely resembles the vulva tissue. This method helps preserve clitoral sensation.

In the initial group of 23 patients who underwent this reconstructive procedure, 90% regained the ability to achieve clitoral orgasm, typically between three and six months after surgery. Sensations may initially be overly or less sensitive, but full recovery is generally achieved within a year. The reconstruction process adds approximately 15 minutes to the original operation time.

This technique may also benefit women who have undergone genital mutilation. The clitoral reconstruction procedure is now being rolled out nationwide as part of a scientific research program, with Radboudumc and eight other Dutch hospitals participating in a follow-up project. Researchers emphasize that while the initial results are promising, further studies are necessary to evaluate the technique's impact on sexual function, quality of life, and safety in clinical practice.