Nerve Sparing Clitoroplasty via a Ventral Approach in a Child With Congenital Adrenal Hyperplasia: A Case Report and Review of the Surgical Technique

Clitoromegaly secondary to congenital adrenal hyperplasia (CAH) poses a significant surgical challenge, requiring preservation of neurovascular integrity alongside satisfactory aesthetic restoration. The optimal timing and operative approach for feminizing genitoplasty remain subjects of ongoing debate. We report a six-year-old girl with classic CAH (Prader stage 3) who underwent nerve-sparing clitoroplasty via a ventral approach. The technique prioritised preservation of the urethral plate, dorsal neurovascular bundle, and clitoral glans. At the six-month follow-up, both the patient and family expressed high satisfaction with cosmetic and functional outcomes. Ventral nerve-sparing clitoroplasty offers reliable aesthetic results with preservation of neurovascular structures. Magnification loupes, meticulous dissection, and intraoperative papaverine irrigation minimise the risk of vasospasm and neurovascular injury. Multidisciplinary care and community-level awareness are essential for timely intervention.