New surgical technique restores clitoral function after vulvar cancer treatment

Vulvar cancer surgery saves lives. It also, often, ends them in a particular way—by removing or damaging the tissue responsible for sexual sensation and orgasm. For four decades, surgeons had no answer to this trade-off. They would excise the tumor, close the wound, and leave the clitoris buried beneath scar tissue, its function largely gone. The assumption seemed to be that survival was enough.

That has changed. Gynecologic oncologist Mieke ten Eikelder and plastic surgeon Tim Nijhuis, both at Radboudumc in the Netherlands, have developed the first surgical technique designed to reconstruct clitoral function after cancer treatment. The procedure works by carefully releasing the nerve bundles that remain after tumor removal, repositioning them to form a new clitoral tip, and then covering the area with a graft of tissue from inside the mouth—material that closely resembles the tissue of the vulva and helps preserve sensation. The entire reconstruction adds roughly fifteen minutes to an operation that is already underway.

The results from the first twenty-three women to undergo the procedure are striking. Ninety percent of them regained the ability to achieve clitoral orgasm, typically within three to six months of surgery. Ten Eikelder notes that sensation can be unpredictable at first—sometimes heightened, sometimes diminished—but generally stabilizes within a year, returning to levels comparable to what patients experienced before their cancer diagnosis. This matters not as an abstract medical victory but as a concrete restoration of sexual function and, by extension, quality of life.

The timing of this development underscores how long the gap has existed. Penile reconstruction after cancer was first performed in 1987. Women with vulvar cancer have been waiting nearly four decades for equivalent care. In the Netherlands alone, approximately four hundred fifty women receive a vulvar cancer diagnosis each year. In about one-quarter of those cases—roughly one hundred twelve women annually—the clitoris or the tissue surrounding it is involved in the tumor. Until now, those women had no option to restore what surgery had taken.

The procedure is now being introduced across the Dutch health system as part of a formal research program. Nine hospitals that treat vulvar cancer are participating, with gynecologic oncologists and plastic surgeons being trained in the new technique. Nijhuis and Ten Eikelder are also training specialists from other countries, suggesting the innovation may soon spread beyond the Netherlands.

The researchers are careful to note that while initial outcomes are encouraging, more work remains. They are conducting a follow-up study across multiple hospitals to determine whether the reconstruction truly improves sexual function and quality of life over the long term, and how the technique can be safely integrated into routine clinical practice. The procedure may also benefit women who have experienced genital mutilation, expanding its application beyond cancer treatment.

What makes this development significant is not merely the technical achievement—though the surgical innovation is real—but the recognition it represents. For decades, the assumption was that a woman who survived vulvar cancer should be grateful, and questions about her sexual function were secondary, or not asked at all. This procedure says something different: that survival and quality of life are not opposing values, that sexual function matters, and that surgeons have a responsibility to preserve it when they can. The work is still early, and the long-term outcomes are still being measured. But for the women in that first group of twenty-three, the difference is already clear.