Skin Conditions

At Urogynecology of Kansas City, we treat vulvovaginal skin conditions that can significantly affect comfort and quality of life. Common diagnoses include the following:

• Lichen sclerosus
• Lichen planus
• Chronic vulvitis
• Recurrent yeast infections
• Contact dermatitis
• Atrophic changes related to menopause

These conditions often present with bothersome symptoms such as itching, burning, pain with intercourse, or persistent irritation. Careful evaluation and individualized treatment—ranging from topical therapies, hormonal support, MLT, to lifestyle modifications—can provide meaningful relief and restore confidence in intimate health.

Clitoral Hood Fusion from Lichen Sclerosus

Lichen sclerosus is a chronic inflammatory skin condition that can cause significant scarring of the vulva when left untreated or inadequately controlled. Over time, the clitoral hood may fuse over the clitoris, and the labia minora can gradually disappear. These changes may lead to decreased sexual sensation, discomfort, hygiene concerns, and emotional distress.

The patient elected to undergo an office-based reconstructive procedure to restore normal anatomy and improve sexual function. The preoperative photographs demonstrate complete clitoral hood fusion with burial of the clitoris beneath scar tissue and obliteration of the normal labia minora architecture.

Because the clitoris contains an intricate network of nerves and blood vessels, meticulous surgical technique is essential. During this procedure, delicate scar tissue was carefully released using a precision radiofrequency surgical device, allowing restoration of the normal clitoral hood and vulvar anatomy while minimizing bleeding and injury to the surrounding tissues.

Following surgery, the patient was instructed to perform gentle daily manual retraction of the clitoral hood to help prevent recurrent adhesions and to continue long-term topical corticosteroid therapy to control the underlying lichen sclerosus. Ongoing follow-up is essential, as lichen sclerosus is a lifelong condition that requires continued medical management to reduce the risk of recurrent scarring.

Although early diagnosis and consistent treatment with topical steroids can often prevent these advanced changes, reconstructive surgery offers an excellent option for women who have already developed significant scarring. In experienced hands, restoration of the clitoral hood and vulvar anatomy can improve comfort, sexual function, hygiene, and quality of life.

Dr. Patrick Nosti specializes in the surgical management of advanced vulvar scarring caused by lichen sclerosus. His office-based reconstructive techniques are designed to restore normal anatomy while preserving the delicate neurovascular structures of the clitoris, helping women regain both function and confidence.