阴蒂粘连的特征在于包皮组织粘附在阴蒂阴蒂上，可以使用非手术方法进行处理，以缓解性功能障碍的症状。
评估与非手术溶解程序相关的疗效和患者满意度，以确定是否适合治疗有症状的阴蒂粘连。
通过使用精细的Jacobsen蚊虫钳将包皮和阴蒂龟头之间的平面分开来进行非手术裂解程序，从粘连下去除包皮和/或角蛋白珍珠，并允许整个龟头的可视化。对61名在1例性医学实践中使用非手术溶解程序治疗阴蒂粘连的妇女进行了图表审查，并向这些患者发送了在线调查。
使用加密的调查回复来评估患者满意度以及手术前后性功能和疼痛的自我报告改善。
在61个符合条件的调查中，收到了41个调查答复（67%的答复率）。绝大多数报告疼痛有所改善（76%），性唤起（63%），和达到性高潮的能力（64％），没有参与者报告这些症状恶化。在手术前报告外部阴蒂刺激无法达到性高潮的16名女性中，6人（38%）能够做到这一点。71％的受访者表示他们对性别的满意度有所改善，83％的受访者表示对他们的决定感到满意。93%的参与者报告说，他们会向有阴蒂粘连的朋友推荐这个程序。
这项研究的结果将帮助临床医生认识到非手术溶解程序作为阴蒂粘连的治疗选择。
这项研究是首次评估接受阴蒂粘连非手术裂解手术的患者队列。其局限性包括1个诊所的样本量小，并且缺乏经过验证的工具来评估手术前后的性功能和疼痛。
提供者应定期检查有性功能障碍症状的患者的阴蒂，以确定他们是否有阴蒂粘连。对于这些患者而言，非手术裂解程序可能是可行的治疗选择，这些患者已表现出满意和症状缓解。迈尔斯MC,RomanelloJP,NicoE,etal.关于患者满意度和非手术性粘连裂解的疗效的回顾性病例系列。JSexMed2022；19：1412-1420。
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.
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.
