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

At a Glance

Category	Detail
Condition	Vulvar carcinoma requiring oncologic excision involving the clitoris
Key Mechanisms	After complete tumor excision, residual clitoral tissue is mobilized by releasing the suspensory ligament while preserving neurovascular structures, then covered with a graft and a new clitoral hood is created.
Target Population	Patients with vulvar cancer who undergo oncologic excision with clitoral reconstruction; the reported series included 18 patients at one center.
Care Setting	Single-center surgical care for vulvar carcinoma; the technique was performed alongside oncologic excision.

Key Highlights

Clitoral sensation was preserved in 16 of 18 patients (89%); the reported sensation categories were 9 comparable with baseline, 4 reduced, and 2 increased.
Sixteen of 18 patients (89%) reported ability to achieve clitoral orgasm after surgery; median time to regain orgasmic function was 3.5 months (range, 1–12 months).
Reconstruction added an estimated 15 minutes to operative time.
Vulvar or inguinal postoperative complications occurred in 7 patients; 2 had complications specifically related to reconstruction.
The small, single-center case series had no systematic comparison group, and sexual function was primarily self-reported.

Guideline-Based Recommendations

Diagnosis

Management

The reported technique followed complete tumor excision and used residual clitoral tissue while preserving neurovascular structures.
The authors reported that reconstruction did not interfere with margin assessment and considered adverse effects on oncologic outcomes unlikely; long-term follow-up is needed to confirm safety.

Monitoring & Follow-up

The study assessed postoperative clitoral sensation and ability to achieve clitoral orgasm, including time to recovery of orgasmic function.
Monitor for graft-site granulation and constricting scar tissue; one patient required reoperation to release an adhesion, after which pain resolved.
Long-term follow-up is needed to assess durability of sensory recovery and oncologic outcomes.

Risks

Reconstruction-specific complications occurred in 2 patients: minor graft-site granulation in one and clitoral pain from constricting scar tissue in another.
The study does not establish the magnitude of functional benefit attributable to reconstruction; it also does not establish comparative superiority of mucosal grafts.

Patient & Prescribing Data

Eighteen patients with vulvar cancer underwent oncologic excision with clitoral reconstruction at a single center.

The technique was adapted from the Foldès method. Full-thickness skin grafts were initially used in 7 patients; the team later transitioned to buccal or vaginal mucosal grafts. All patients treated with the refined technique reported equal or increased postoperative sensation, but the study does not establish comparative superiority.

Clinical Best Practices

The reported technique involved complete tumor excision before reconstruction and preservation of neurovascular structures during mobilization of residual clitoral tissue.
Interpret reported functional outcomes in light of the small case series, lack of a comparison group, and reliance primarily on self-report.
The authors called for prospective studies with longer follow-up and multicenter collaboration.