Dyspareunia occurs in 24.7-36.8% of women. Clitorodynia is uncommon and confined to the glans clitoris, clitoral shaft and adjacent prepucial area. In a subgroup, vulvoscopy shows adhesions of adjacent skin to the glans with numerous keratin pearls and sebum emanating through adhesions concealing the glans corona. Persistent balanitis underneath appears to account for clitoral pain or persistent genital arousal disorder (PGAD). Instead of dorsal slit surgery of the clitoral hood with lysis of clitoral adhesions under general anesthesia, we now perform an in-office procedure under local anesthesia with a dorsal nerve block for the management of clitorodynia secondary to clitoral adhesions. We reviewed 7 patients (mean age 37 years, range 18 – 62 years) who had adhesions from the clitoral hood to the glans, obscuring the corona of the glans clitoris. Vulvoscopy identified smegma underneath the adhesions. All 7 underwent in-office management of clitoral adhesions. A dorsal nerve block was performed with 5 mL of either of mixture lidocaine/bupivacaine or bupivacaine liposome injectable suspension. After adequate local anesthesia was achieved, a Jacobson hemostat forceps was used to bluntly lyse epithelial adhesions and remove underlying keratin pearls. This process was continued until the corona was visualized completely around the circumference of the glans clitoris. An additional 5 mL of local anesthetic was injected around the prepuce and frenulum of the clitoris for post-operative pain control. The patient was instructed to tub soak the area twice a day and carefully retract the clitoral hood sufficiently to visualize the corona while in the bath to prevent re-adherence of the adjacent clitoral hood to the glans. Even after the initial healing period the corona should be observed by retracting the hood daily to prevent adhesions. None of the patients had recurrence of adhesions 6 months post procedure. 5/7 women had significant reduction of clitoral pain.