Surgical Technique Restores Clitoral Sensation After Vulvar Cancer

A New Approach to Clitoral Reconstruction

Surgeons at Radboud University Medical Center (Radboudumc) developed a reconstructive procedure that restores clitoral structure and sexual function after vulvar cancer surgery. Plastic surgeon Tim Nijhuis and gynecologic oncologist Mieke ten Eikelder designed the operation to prevent permanent nerve loss. The technique arrives nearly four decades after the first penile reconstruction surgery was performed in 1987.

Standard surgical treatment for vulvar cancer previously closed the operative wound directly over the excised area. This standard approach left the remaining clitoral anatomy buried under scar tissue, offering patients limited support for post-treatment sexual recovery. The new protocol actively repositions surviving neural pathways rather than sealing them beneath skin flaps.

Repositioning Nerve Bundles and Mucosal Grafts

The procedure mobilizes existing nerve bundles to form a new clitoral tip once the tumor is cleared. Surgeons release the preserved neural tissue and secure it at the anatomical apex. They then cover the reconstituted tip with a graft harvested from the buccal mucosa inside the cheek.

Buccal mucosal tissue closely mirrors the cellular properties of tissue surrounding the vulva. Harvesting this oral tissue helps protect nerve endings while encouraging sensation retention. Integrating the entire reconstructive step adds approximately 15 minutes to the primary oncologic surgery.

Sensation Recovery and Patient Outcomes

Ninety percent of patients in the initial 23-person cohort regained clitoral orgasmic capacity after undergoing the reconstruction. Most participants reported achieving orgasm between three and six months following their operation. The peer-reviewed findings appeared in the journal Gynecologic Oncology.

Sensory recovery fluctuates during the initial healing period. Patients often experience either diminished sensation or heightened sensitivity across the first several weeks. According to the study authors, nerve adaptation stabilizes within one year, returning clitoral sensation to baseline pre-surgical levels for most patients.

Broader Application and Training Across Treatment Centers

Approximately 450 women receive a vulvar cancer diagnosis each year in the Netherlands, with one-quarter involving clitoral tissue. The technique may also offer reconstructive utility for women who have undergone female genital mutilation. Eight additional Dutch hospitals treating vulvar cancer have joined a scientific program to train surgical teams in the method.

Researchers continue to evaluate patient outcomes to ensure the procedure integrates safely into routine oncologic workflows. Talk to your surgical team or oncologist about nerve-sparing options if you face upcoming surgical resection for pelvic malignancies.