Clitoral reconstruction may preserve sexual function

Nearly 90% of patients reported preserved clitoral sensation and the ability to achieve orgasm following reconstruction.

By
Andrea Surnit
October 7, 2026
3 min

MDSpire News

Overview

In a single-center series of 18 patients undergoing surgery for vulvar carcinoma, clitoral sensation and ability to achieve clitoral orgasm were each reported by 89% after anatomically informed reconstruction. The findings describe early experience with the procedure; the small cohort, lack of a comparison group, self-reported outcomes, and limited follow-up prevent conclusions about comparative benefit or long-term safety.

Background

Surgery for vulvar carcinoma may involve excision near the clitoris, with potential consequences for sexual function. The described technique mobilizes residual clitoral tissue after tumor excision while preserving neurovascular structures, then covers the tissue with a graft and creates a new clitoral hood. The 2023 ESGO guideline states that limiting surgical radicality to preserve structure and function can be acceptable and often desirable, and identifies reconstructive surgical skills as relevant to functional outcomes. Oncologic excision and margin assessment remain central to the approach described in the case series.

Data Highlights

Outcome	Finding
Patients treated	18
Postoperative clitoral sensibility preserved	89% (16 patients)
Reported ability to achieve clitoral orgasm	89% (16 patients)
Time to regain orgasmic function	Median 3.5 months; range 1–12 months
Estimated additional operative time	15 minutes
Vulvar or inguinal postoperative complications	7 patients
Complications specifically related to reconstruction	2 patients

Key Findings

The technique followed complete tumor excision and mobilized residual clitoral tissue by releasing the suspensory ligament while preserving neurovascular structures.
Sixteen of 18 patients (89%) reported preserved clitoral sensibility; 9 described sensation comparable with their preoperative baseline, 4 reduced sensitivity, and 2 increased sensitivity.
Sixteen patients (89%) reported being able to achieve clitoral orgasm after surgery. Median time to regain orgasmic function was 3.5 months, with a range of 1–12 months.
Seven patients received full-thickness skin grafts; four reported diminished sensation or numbness. After the team transitioned to buccal or vaginal mucosal grafts, all patients treated with the refined technique reported equal or increased sensation. The case series does not establish comparative superiority of mucosal grafts.
Two complications were specifically attributed to reconstruction: minor graft-site granulation in one patient and constricting scar tissue with clitoral pain in another, which resolved after reoperation to release the adhesion.
The authors reported that reconstruction did not interfere with margin assessment and considered adverse effects on oncologic outcomes unlikely, while noting that long-term follow-up is needed to confirm safety.

Clinical Implications

The series describes a reconstructive option that preserved reported sensation and orgasmic function for many patients, while adding an estimated 15 minutes to operative time. Its uncontrolled design and reliance primarily on self-reported sexual function mean that the magnitude of benefit attributable to reconstruction and the durability of outcomes remain uncertain; the authors call for prospective studies with longer follow-up and multicenter collaboration.

Conclusion

Clitoral reconstruction after vulvar cancer excision was feasible in this small single-center series, with most patients reporting preserved sensation and orgasmic ability. Comparative effectiveness and long-term functional and oncologic outcomes remain to be established.