PS-03-003 Surgical treatment of clitoral phimosis and its effects on female sexual functions

Abstract

We aimed to determine the etiology of clitoral phimosis, its influence on sexual function, and outcomes after surgical treatment. In this prospective cohort study, we observed the occurrence of clitoral phimosis and related changes in a group of 3,650 sexually active heterosexual women with a mean age of 34.8 ± 14.9 years (20–45 years) from September 2014 to September 2016. Ultimately, we compared the changes in sexual function and distress and satisfaction with postoperative genital appearance in nine patients with severe clitoral phimosis at 12 months after surgical treatment. Various forms of CP were found in 46 of 3,650 patients (1.3%). Severe forms of CP were found in 9 cases, but it was complicated by stenosis of vaginal introitus (SVI) in only two cases. These nine patients underwent circumcision and two of them underwent perineoplasty. FSD occurred mainly in those with LS and severe forms of phimosis. Sexual function, as indicated by the total FSFI score, was significantly improved at 12 months postoperatively (17.9 ± 0.9 vs. 26.6 ± 0.5; p<0.001). The FGSIS score assessing genital perception was significantly higher postoperatively than preoperatively in women who underwent clitoral circumcision (20 ± 3.0 vs. 12.3 ± 3.3; p<0.001). The FSDS-R score was significantly lower postoperatively than before (21.3 ± 6.2 vs. 33.8 ± 6.9 vs.; p<0.001). Sexual function in two women with CP and SVI improved postoperatively, but the sexual distress level did not decrease significantly.