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Clitoridectomy

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Clitoridectomy

Clitoridectomy or clitorectomy is the surgical removal, reduction, or partial removal of the clitoris. It is rarely used as a therapeutic medical procedure, such as when cancer has developed in or spread to the clitoris. Commonly, non-medical removal of the clitoris is performed during female genital mutilation.

A clitoridectomy is often done to remove malignancy or necrosis of the clitoris. This is sometimes done along with a radical complete vulvectomy. Surgery may also become necessary due to therapeutic radiation treatments to the pelvic area.

Removal of the clitoris may be due to malignancy or trauma.

Female infants born with a 46,XX genotype but have a clitoris size affected by congenital adrenal hyperplasia and are treated surgically with vaginoplasty that often reduces the size of the clitoris without its total removal. The atypical size of the clitoris is due to an endocrine imbalance in utero. Other reasons for the surgery include issues involving microphallism and those who have Müllerian agenesis. Treatments on children raise human rights concerns.

Clitoridectomy surgical techniques are used to remove an invasive malignancy that extends to the clitoris. Standard surgical procedures are followed in these cases. This includes evaluation and biopsy. Other factors that will affect the technique selected are age, other existing medical conditions, and obesity. Other considerations are the probability of extended hospital care and the development of infection at the surgical site.

The surgery proceeds with the use of general anesthesia, and prior to the vulvectomy/clitoridectomy an inguinal lymphadenectomy is first done. The extent of the surgical site extends 1 to 2 cm (0.39 to 0.79 in) beyond the boundaries of malignancy. Superficial lymph nodes may also need to be removed. If the malignancy is present in any muscles in the region, then the affected muscle tissue is also removed. In some cases, the surgeon is able to preserve the clitoris despite extensive malignancy. The cancerous tissue is removed and the incision is closed.

Post-operative care may employ the use of suction drainage to allow the deeper tissues to heal toward the surface. Follow-up after surgery includes the stripping of the drainage device to prevent blockage. A typical hospital stay can last up to two weeks. The site of the surgery is left unbandaged to allow for frequent examination.

Complications can include the development of lymphedema; not removing the saphenous vein during the surgery can help prevent this. In some instances, the buildup of fluid can be reduced through methods such as foot elevation, diuretic medication, and wearing compression stockings.

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