LAUSR

of clitoris and biopsies of nerve-resembling tissue were obtained for histologic analyses. Descriptive statistics were used for data analyses. RESULTS: Seventeen cadavers (ages 48 to 89) were examined. Length of clitoral body was 29 mm (range, 17-46 mm) and width was 7 (511) mm. Length of crura was 49 (25-68) mm and width at anterior aspect was 9 (5-13) mm. Glans was 9 (6-12) mm long and 4 (3-6) mm wide at its proximal portion. Closest distance from glans to urethra was 25 (14-37) mm and superior clitoral body to mid pubic arch was 27 (14-46) mm. Width of DNC at lateral crura was 3 (2-4) mm and at distal body was 1 (1-2) mm. Distance from DNC as it emerged from PM to mid pubic arch was 35 (20-48) mm and to posterior surface of PM was 19 (8-31) mm. The DNC and artery of clitoris coursed adjacent to medial surface of inferior pubic ramus surrounded by a dense fibrous capsule adherent to periosteum. They passed between PM and crura and emerged from lateral aspect of crura at the 10-11 o’clock position on right side and at 1-2 o’clock position on left, relative to the urethra (Figure 1). Nerve and artery then coursed deep to dense connective tissue sheath, which was contiguous with the suspensory ligament and fascia of clitoris. Figure 2 depicts the orientation of DNC relative to the clitoral body as it coursed towards the glans. Histological examination of tissue biopsied confirmed presence of neural tissue in all specimens sampled. CONCLUSION: Precise knowledge of clitoral anatomy and associated neurovascular structures is essential to safely complete partial vulvectomies, clitoral and vulvar reconstructive procedures, anti-incontinence surgeries and repair of obstetric lacerations; it is also important in managing localized pain and evaluating sexual dysfunction. Though the DNC courses deep to dense connective tissue layers, inadvertent injury may occur in setting of deep dissection or suture placement. The DNC seems most vulnerable with surgical entry or lacerations that extend from the midline of the prepuce to the lateral surfaces of inferior pubic rami.