title: A novel approach to the surgical management of clitoral phimosis.
abstract: BACKGROUND
  The objective of this case series was to outline a novel method for surgical correction of clitoral phimosis caused by vulvar lichen sclerosus (LS) or lichen planus (LP) and to review the postoperative outcomes.
  
  
  METHODS
  We used the CO2 laser to treat clitoral phimosis in 20 women with LS and three women with LP. All patients underwent individualized preoperative and postoperative topical therapy with steroids or immunomodulators. Five women with LS had mild reagglutination during follow-up but were satisfied with the results, and three required reoperation, with satisfactory results in follow-up. Two women with LP required reoperation.
  
  
  CONCLUSIONS
  This novel surgical technique has enabled the treatment of clitoral phimosis secondary to LS or LP, but further studies are required. Medical maintenance therapy postoperatively is a vital component of treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto ON.
authors.forename: Jamie
authors.initials: J
authors.lastname: Kroft
authors.affiliation: Department of Obstetrics and Gynecology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto ON.
authors.forename: Michael
authors.initials: M
authors.lastname: Shier
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D002987:Clitoris / Q000473:pathology* / Q000601:surgery*; D004967:Estrogens / Q000627:therapeutic use; D005260:Female; D006801:Humans; D054020:Lasers, Gas / Q000627:therapeutic use*; D008010:Lichen Planus / Q000150:complications* / Q000473:pathology; D008875:Middle Aged; D011374:Progesterone / Q000627:therapeutic use; D007724:Vulvar Lichen Sclerosus / Q000150:complications* / Q000473:pathology
chemical_list: D000305:Adrenal Cortex Hormones; D004967:Estrogens; D011374:Progesterone