Anatomy of the prepuce of the clitoris: Introducing the collar of the clitoris, a novel anatomical subdivision of the clitoral prepuce

The anatomy of the clitoral prepuce is surgically important, especially as female genital mutilation remains common and genital plastic, reconstructive, and aesthetic surgeries are performed with increasing frequency. Despite its surgical importance, basic anatomical study of the clitoral prepuce has been limited, and confusion exists regarding the fundamental gross anatomical structure of the prepuce. This study identifies novel anatomical structures of the clitoral prepuce including a distinct band of preputial tissue located around the neck of the clitoris, a structure which has not yet been described in the literature. The aforementioned structure, referred to here as the collar of the clitoris, was assessed through a review of digital images taken of 141 donor bodies. The presence of the collar was confidently identified in images of 130:141 bodies (80:83 unembalmed donor bodies; 50:58 embalmed donor bodies); the absence of the collar was confidently identified in 0:141; and the presence/absence of the collar was unclear in 11:141 (3:83 unembalmed donor bodies; 8:58 embalmed donor bodies). Thus, the collar of the clitoris was present in ≥92.2% of donor bodies and absent in ≤7.8%. This report posits that the typical clitoral prepuce consists of two main components: a superficial clitoral hood and an underlying clitoral collar. Further, this report presents a method for characterization of preputial anatomical variation by means of considering the clitoral collar as a fundamental anatomical structure. This study improves the understanding of the clitoral prepuce and has important implications for genital plastic, reconstructive, and aesthetic surgeries.