Chicago Medical School at Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA.
Rush Medical College at Rush University, Chicago, IL, USA.
J Sex Med. 2022 Sep;19(9):1412-1420. doi: 10.1016/j.jsxm.2022.06.011. Epub 2022 Jul 20.
Clitoral adhesions are characterized by adherence of preputial tissue to the glans clitoris and can be managed using a non-surgical approach in order to relieve symptoms of sexual dysfunction.
To evaluate efficacy and patient satisfaction associated with the non-surgical lysis procedure in order to determine if it is an appropriate treatment for symptomatic clitoral adhesions.
The non-surgical lysis procedure is performed by using a fine Jacobsen mosquito forceps to separate the plane between the prepuce and the glans of the clitoris, removing smegma and/or keratin pearls from underneath the adhesions and allowing for visualization of the entire glans. A chart review of 61 women that were treated for clitoral adhesions using the non-surgical lysis procedure at 1 sexual medicine practice was performed and an online survey was sent to these patients.
Encrypted survey responses were used to evaluate patient satisfaction as well as self-reported improvement in sexual functioning and pain before and after the procedure.
41 survey responses were received out of 61 eligible (67% response rate). A large majority reported improvement in pain (76%), sexual arousal (63%), and ability to achieve orgasm (64%) and no participants reported worsening in these symptoms. Of the 16 women that reported the inability to orgasm from external clitoral stimulation prior to the procedure, 6 (38%) were able to do so afterwards. Seventy-one percent of respondents reported improvement in their satisfaction with sex and 83% reported being satisfied with their decision to have the procedure. Ninety-three percent of participants reported that they would recommend this procedure to a friend with clitoral adhesions.
The results of this study will help clinicians to recognize the non-surgical lysis procedure as a treatment option for clitoral adhesions.
STRENGTHS & LIMITATIONS: This study is the first of its kind assessing a cohort of patients undergoing the non-surgical lysis procedure for clitoral adhesions. Its limitations include a small sample size from 1 clinic and lack of validated instrument to evaluate sexual function and pain before and after the procedure.
Providers should regularly examine the clitoris of patients with symptoms of sexual dysfunction in order to determine if they have clitoral adhesions. The non-surgical lysis procedure may be a viable therapeutic option for these patients that has demonstrated both satisfaction and symptom relief. Myers MC, Romanello JP, Nico E, et al. A Retrospective Case Series on Patient Satisfaction and Efficacy of Non-Surgical Lysis of Clitoral Adhesions. J Sex Med 2022;19:1412-1420.
阴蒂粘连的特征是包皮组织粘到阴蒂头，可以采用非手术方法进行治疗，以缓解性功能障碍的症状。
评估非手术松解术的疗效和患者满意度，以确定其是否是治疗有症状的阴蒂粘连的合适方法。
非手术松解术是使用精细的 Jacobsen 蚊式钳分离包皮和阴蒂头之间的平面，清除粘连下方的污垢和/或角蛋白珠，并使整个阴蒂头可见。对在 1 家性医学诊所接受非手术松解术治疗阴蒂粘连的 61 名女性进行了图表回顾，并向这些患者发送了在线调查。
加密的调查回复用于评估患者满意度以及治疗前后自我报告的性功能改善和疼痛情况。
61 名符合条件的患者中收到了 41 份调查回复（回复率为 67%）。大多数患者报告疼痛（76%）、性唤起（63%）和达到性高潮的能力（64%）得到改善，没有患者报告这些症状恶化。在 16 名报告在手术前无法通过外部阴蒂刺激达到性高潮的女性中，有 6 名（38%）在手术后能够达到性高潮。71%的受访者报告对性生活的满意度提高，83%的受访者对接受该手术的决定表示满意。93%的参与者表示，他们会向有阴蒂粘连的朋友推荐这种手术。
这项研究的结果将帮助临床医生认识到非手术松解术是治疗阴蒂粘连的一种治疗选择。
这是第一项评估接受非手术松解术治疗阴蒂粘连的患者队列的研究。其局限性包括来自 1 家诊所的样本量较小，以及缺乏用于评估手术前后性功能和疼痛的经过验证的工具。
医生应定期检查有性功能障碍症状的患者的阴蒂，以确定他们是否患有阴蒂粘连。非手术松解术可能是一种可行的治疗选择，为这些患者带来了满意度和症状缓解。Myers MC、Romanello JP、Nico E 等人。非手术松解阴蒂粘连患者的满意度和疗效的回顾性病例系列研究。J 性医学 2022;19:1412-1420.
