Abstract：
Clitoral adhesions occur when the prepuce adheres to the glans. These adhesions have been found in up to 22% of women seeking evaluation for sexual dysfunction. The etiology of clitoral adhesions remains largely unclear. Studies published to date on the presentation and management of clitoral adhesions are relatively recent and raise questions for future research.
We sought to provide a background of existing knowledge on the prevalence, presentation, etiology, associated conditions, and management of clitoral adhesions and to identify areas for future research.
A review of literature was performed for studies that investigate clitoral adhesions.
Conditions associated with chronic clitoral scarring appear to have a role in the development of clitoral adhesions. Symptoms include clitoral pain (clitorodynia), discomfort, hypersensitivity, hyposensitivity, difficulty with arousal, and muted or absent orgasm. Complications include inflammation, infection, and the development of keratin pearls and smegmatic pseudocysts. There are surgical and nonsurgical interventions to manage clitoral adhesions. Additionally, topical agents can be included in conservative and/or postprocedural management. Although many studies on clitoral adhesions are limited to patients with lichen sclerosus (LS), clitoral adhesions are not confined to this population.
Areas for future research include etiologies of clitoral adhesion; such knowledge is imperative to improve prevention and management. Also, in previous studies, patients were instructed to apply various topical agents and manually retract the prepuce for conservative management or postlysis care. However, the efficacy of these interventions has not been investigated. Surgical and nonsurgical lysis procedures have been described for the management of pain and difficulties with arousal and orgasm that are causes of the sexual dysfunction associated with clitoral adhesion. Although previous studies have assessed efficacy and patient satisfaction, many of these studies were limited to small sample sizes and focused solely on patients with LS. Future studies are needed to inform a standard of care for the management of clitoral adhesions.
We sought to provide a background of existing knowledge on the prevalence, presentation, etiology, associated conditions, and management of clitoral adhesions and to identify areas for future research.
A review of literature was performed for studies that investigate clitoral adhesions.
Conditions associated with chronic clitoral scarring appear to have a role in the development of clitoral adhesions. Symptoms include clitoral pain (clitorodynia), discomfort, hypersensitivity, hyposensitivity, difficulty with arousal, and muted or absent orgasm. Complications include inflammation, infection, and the development of keratin pearls and smegmatic pseudocysts. There are surgical and nonsurgical interventions to manage clitoral adhesions. Additionally, topical agents can be included in conservative and/or postprocedural management. Although many studies on clitoral adhesions are limited to patients with lichen sclerosus (LS), clitoral adhesions are not confined to this population.
Areas for future research include etiologies of clitoral adhesion; such knowledge is imperative to improve prevention and management. Also, in previous studies, patients were instructed to apply various topical agents and manually retract the prepuce for conservative management or postlysis care. However, the efficacy of these interventions has not been investigated. Surgical and nonsurgical lysis procedures have been described for the management of pain and difficulties with arousal and orgasm that are causes of the sexual dysfunction associated with clitoral adhesion. Although previous studies have assessed efficacy and patient satisfaction, many of these studies were limited to small sample sizes and focused solely on patients with LS. Future studies are needed to inform a standard of care for the management of clitoral adhesions.
摘要：
背景：当包皮粘附到龟头时，会发生阴蒂粘连。在高达22％的寻求性功能障碍评估的女性中发现了这些粘连。阴蒂粘连的病因仍不清楚。迄今为止发表的关于阴蒂粘连的表现和管理的研究是相对较新的，并为未来的研究提出了问题。
目的：我们试图提供有关患病率的现有知识背景，介绍,病因学,相关条件,以及阴蒂粘连的管理，并确定未来研究的领域。
方法：对研究阴蒂粘连的研究进行了文献综述。
结果：与慢性阴蒂瘢痕形成相关的病症似乎在阴蒂粘连的发展中起作用。症状包括阴蒂疼痛（阴蒂痛），不适,超敏反应，敏感性低下，唤醒困难，消音或没有高潮。并发症包括炎症，感染,以及角蛋白珍珠和涂片假性囊肿的发展。有手术和非手术干预措施来管理阴蒂粘连。此外,保守和/或术后管理可以包括局部用药.尽管许多关于阴蒂粘连的研究仅限于硬化性苔藓（LS）患者，阴蒂粘连并不局限于该人群。
结论：未来研究的领域包括阴蒂粘连的病因；这些知识对于改善预防和管理至关重要。此外，在以前的研究中，我们指导患者应用各种外用药物,并手动收回包皮以进行保守治疗或溶解后护理.然而,这些干预措施的疗效尚未得到研究.已经描述了手术和非手术溶解程序，用于治疗疼痛以及唤醒和性高潮的困难，这是导致与阴蒂粘连相关的性功能障碍的原因。尽管以前的研究已经评估了疗效和患者满意度，其中许多研究仅限于小样本量,并且仅针对LS患者.未来的研究需要为阴蒂粘连的管理提供标准的护理。
目的：我们试图提供有关患病率的现有知识背景，介绍,病因学,相关条件,以及阴蒂粘连的管理，并确定未来研究的领域。
方法：对研究阴蒂粘连的研究进行了文献综述。
结果：与慢性阴蒂瘢痕形成相关的病症似乎在阴蒂粘连的发展中起作用。症状包括阴蒂疼痛（阴蒂痛），不适,超敏反应，敏感性低下，唤醒困难，消音或没有高潮。并发症包括炎症，感染,以及角蛋白珍珠和涂片假性囊肿的发展。有手术和非手术干预措施来管理阴蒂粘连。此外,保守和/或术后管理可以包括局部用药.尽管许多关于阴蒂粘连的研究仅限于硬化性苔藓（LS）患者，阴蒂粘连并不局限于该人群。
结论：未来研究的领域包括阴蒂粘连的病因；这些知识对于改善预防和管理至关重要。此外，在以前的研究中，我们指导患者应用各种外用药物,并手动收回包皮以进行保守治疗或溶解后护理.然而,这些干预措施的疗效尚未得到研究.已经描述了手术和非手术溶解程序，用于治疗疼痛以及唤醒和性高潮的困难，这是导致与阴蒂粘连相关的性功能障碍的原因。尽管以前的研究已经评估了疗效和患者满意度，其中许多研究仅限于小样本量,并且仅针对LS患者.未来的研究需要为阴蒂粘连的管理提供标准的护理。
