Causes of clitoromegaly are divided into hormonal factors such as congenital adrenal hyperplasia and non-hormonal factors such as tumor. Other etiologies include idiopathic causes and pseudoclitoromegaly [
3]. Clitoromegaly causes serious psychological stress, and treatment should be performed before 6 to 12 months of age in order to minimize any psychological sequelae [
4]. A careful history, physical examination, and hormonal analysis are needed to reach an underlying cause, because clitoromegaly may result from a variety of factors [
5]. Techniques for clitoral resection have changed a great deal over the past thirty years as our knowledge of the anatomy has improved. In the past, removal of the whole clitoris (clitorectomy) was used, but is not now an acceptable option because the clitoris is recognized as an important sensory organ involved in sexual response [
6]. Later, surgeons tried to preserve as much of the enlarged clitoris as possible and buried the corpora under the skin. However, this meant that the erectile tissue was concertinaed under the skin and, when erect, was very painful [
7]. Further modifications of the technique involved excision of corporal tissue and preservation of the glans and the neurovascular bundle to reduce any loss of sensation [
8]. On the basis of an extensive study of these techniques, we individualized and combined the most important points of other techniques with our refinements to obtain a better cosmetic result and to preserve clitoral sensitivity. For example, in Papageorgiou et al. [
4], both the dorsal and ventral neurovascular bundles were preserved and the glans was untouched. In Kogan et al. [
9], the dorsal neurovascular bundle was preserved and the dorsal central wedge glans reduction was performed. However, the surgeon did not reduce the size of the glans clitoris sufficiently, which resulted in an unsightly longitudinal scar on the dorsum of the glans clitoris. Selvaggi et al. [
8] removed the glans clitoris bilaterally, but we reduced the glans on the ventral side where the density of nerves is lowest [
10]. Ventral glans reduction also has the advantage of hiding the surgical scar and easing the removal of a sufficient amount of tissue. Additionally, we left a wide width of the dorsal neurovascular bundle. This is due to the dorsal nerve, which is widely distributed on the dorsum of the phallus. Finally, in order to cover the glans in a resting state, we constructed a prepuce by trimming the skin. By modifying the various procedures used previously, this operation satisfied both the functional and aesthetic desires of the patient and patient’s parents.