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The first comprehensive evaluation of clitoral anatomy was reported by De Graaf in the 17th century, followed by the study of Kobelt in the 19th century.

Cadaver studies and magnetic resonance download fucking fat clitoris waptrick porn recently managed to clarify the exact position, structure, and innervation of the human clitoris [ 12 ].

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Clitoris is defined as a highly innervated and vascular erectile structure, consisting of the glans and paired erectile bodies—bulbs, crura, and corpora. The intimate relation of these erectile tissues to distal urethra and vagina is believed to have an fuckinng role in sexual response. Nevertheless, there are certain aspects of innervation, histology, and physiology of the clitoris download fucking fat clitoris still remain unclear, making our knowledge of the correlation between clitoral anatomy, sexual function, and genital surgery incomplete [ 34 ].

Therefore, clitoral reconstructive surgery still poses a great challenge for the genital surgeon, encompassing many different procedures and techniques. Total amputation of download fucking fat clitoris clitoris used to be the single treatment for patients with clitoris hypertrophy disorders of sexual development, congenital adrenal hyperplasiacausing female genital mutilation.

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In fatbigpussypics to preserve sensation and achieve better aesthetic appearance, download fucking fat clitoris refined fownload of recession and reduction clitoroplasty have been described [ 5 ].

Female to male transgenderism is another indication for clitoral reconstructive surgery, where the creation of a neophallus from a hormonally hypertrophied clitoris plays a crucial role. Refinements of the technique were described afterwards by other authors. Hage presented his experience in 32 female to male transsexuals, achieving small phallus, that is, hardly capable of sexual penetration [ 7 ].

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Perovic and Djordjevic reported their metoidioplasty technique, that is, based on repair of the most severe forms of hypospadias and intersex [ 8 ]. The main goals of the procedure are male appearance of the genitalia and voiding while standing, without compromising sexual function.

We evaluated the principles of metoidioplasty to determine the importance of clitoral anatomy in female to male gender reassignment surgery.

Between March and January97 fkcking transsexuals, aged 18—41 years mean 29 www sex free 3gp, underwent single stage metoidioplasty, in line with the Standards of Care of the World Professional Download fucking fat clitoris for Transgender Health [ 9 ]. After Institutional Download fucking fat clitoris Committee approval, informed consent was signed by all patients tat the procedure.

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The patients were treated hormonally prior to surgery and underwent hysterectomy and adnexectomy either before 63 cases or download fucking fat clitoris 34 cases with metoidioplasty. To achieve additional enlargement of the clitoris, patients were advised download fucking fat clitoris use dihydrotestosterone gel twice a day for a period of 3 months prior to surgery, combined with a vacuum device also twice a day for 30 minutes. Preoperative length of the hypertrophied clitoris ranged from 2.

Schematic presentation of clitoral anatomy in metoidioplasty. Preoperative appearance of genital area.

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Clitoral bodies and glans are hormonally enlarged. Labia majora resemble scrotums. The current operative procedure includes the following download fucking fat clitoris Vaginectomy is performed by total removal of vaginal mucosa colpocleisisexcept the part of anterior vaginal wall near the urethra, which is used for urethral lengthening.

Incision is made circumferentially between the inner and outer layers of the clitoral prepuce and continued around the urethral plate and native urethra.

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After degloving, the clitoral ligaments are completely clitorks to bring the clitoris forward. The ligamentous support of the clitoris—suspensory ligament—consists of superficial and deep components.

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These components are multiplanar, keeping the clitoral download fucking fat clitoris curved. Therefore, its main role is to prevent the clitoris from straightening, while maintaining its stability during sexual activity Figure 1 b. Additional curvature is due to short, undeveloped, wide urethral plate, which adheres ventrally to clitoral bodies Figures 1 c and 2 c. In order to straighten and lengthen the clitoris as much as possible, ligamentous components need to be download fucking fat clitoris released and also urethral plate needs to be divided Figure 3.

Care must be taken to avoid injury of the neurovascular structures during this maneuver.

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Paired clitoral neurovascular bundle originates from pudendal neurovascular bundle, ascending to the upper part of the clitoral body where the crura unite. The dorsal clitoral nerves pass in fuccking fibers to enter the deep layers of the glans, without download fucking fat clitoris distal branches that reach the tip of the clitoris.

Analogously to glans penis innervation, the innervation of the glans clitoris is impressive, particularly in its dorsal part. Ventrally, the wide and undeveloped urethral plate is dissected from the clitoral bodies.

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It is imperative to prevent injury of spongiosal tissue around the urethral plate and excessive bleeding, and also to preserve the blood supply to the urethral plate. Dissection includes the bulbar part of the plate surrounding the native orifice to provide good mobility for shmal and grils sexy hd reconstruction.

Since the wide urethral plate is always short and adheres to the corporal bodies, causing the ventral clitoral curvature, it is divided at downloas level of glanular corona. This downlaod a download fucking fat clitoris straightening and lengthening of the clitoris. Clit Teen Latina Webcam Amateur.

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