Preliminary Exploration of a New Clitoral Hood Classification System and Treatment Strategy

Background Increasing attention has been given to clitoral hoods in recent years, but few studies have been conducted on the classification and treatment strategies of clitoral hood hypertrophy. The purpose of this article is to introduce a new system of clitoral hood classification based on relevant anatomy and make recommendations for clitoral hood reduction. Methods The clitoral hood region is divided into the central zone (zone C) and the lateral zone (zone L). According to the anatomical characteristics of each zone, patients can be divided into 5 types: standard form, central hypertrophy, lateral hypertrophy, composite hypertrophy and special type. Central hypertrophy is further divided into wide and long clitoral hoods, and horizontal and vertical redundancy are addressed using bilateral clitoral hood triangular skin resection and inverted horizontal V-shaped skin resection, respectively. Lateral hypertrophy can be treated with vertically oriented excision. Composite hypertrophy is corrected by combining these methods to remove redundant tissue depending on the situation. Results 1135 patients were classified according to the new classification system and 789 participants were given corresponding treatment measures. Thirty-four patients (4.3%) experienced complications, and 15 (1.9%) underwent revision surgery. Six months after the procedure, clitoral hood images improved significantly without paresthesia, and the overall satisfaction rate of the patients regarding clitoral hood reduction was 95.7%. Conclusions The clitoral prepuce is an important part of the aesthetic unit of female vulva. The new clitoral hood classification strategy systematically summarizes the anatomical characteristics of the clitoral hood and clearly makes recommendations for surgical options. Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .