Surgical anatomy of the dorsal nerve of the clitoris.

Aims: The purpose of this study was to describe the distal pathway of the dorsal nerve of the clitoris (DNC) from gross anatomical and histological studies of cadaver specimens.

Methods: We performed dissections on 14 intact adult cadaver vulva specimens using 2× loupe magnification and microscopy. The DNC was identified by gross dissection and confirmed histologically by staining with hematoxylin and eosin (H&E), Masson's trichrome (MT), and S100 antibody. The DNC pathway and its branches were followed from the pubic rami to the glans clitoris.

Results: The DNC travels inferior to the inferior pubic ramus along the superior/posterior edge of the clitoral crus. At the angle of the clitoral body, inferior to the pubic symphysis, the DNC enters the deep component of the suspensory ligament, which attaches to the clitoral body and to the pubic symphysis. The dorsal nerves, at the angle of the clitoral body, travel along the dorsal aspect of the clitoral body at the 11 and 1 o'clock positions. At the base of the clitoral body, the DNC is suspended superiorly away from the tunica. Distally along the clitoral body, the DNC descends and runs along the tunica and enters the glans. Within the glans, the terminal fibers are widely dispersed, and numerous receptors populate the supporting tissue of the glans beneath the epithelium.

Conclusions: The detailed description of the distal course of the nerve presented here has not been previously described in adult humans and is pertinent for surgical procedures involving the clitoris.