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PubMed1975

[Studies on the pudendal nerve. Part 4. A macroscopical observation of the branches of the pudendal plexus in dogs and cats (author's transl)].

The pudendal plexus and its branches of 20 dogs and 20 cats have been observed macroscopicaly. The main findings are summarized as follows: 1) The pudendal plexus in dogs is formed most frequently by the ventral rami of the first, second and third sacral nerves. 2) The bigeminal nerve of dogs and cats is formed respectively by the union of the ventral rami mentioned above. 3) The perineal nerve in dogs arises with one root from the bigeminal nerve and that of cats two roots, of which the main root arises from the points where the bigeminal nerve joins the asciatic nerve and the accessory one from the bigeminal nerve. 4) In dogs and cats the dorsal nerve of the penis or clitoris arises from the main trunk of the perineal nerve (Fig. 5, type IB) at an average rate of 57.5%. 5) In the dogs and cats, the inferior rectal nerve consists of two divisions; a division had the branches which are derived the perineal nerve to supply the skin around the anus and the other branches which arises from the muscular branch of the dorsal nerve of the penis or clitoris to supply the Sphincter ani externus. 6) The muscular branch of dogs and cats which is analogous to that of the perineal nerve in man, arises from the dorsal nerve of the penis or clitoris. 7) In dogs and cats the muscular branch to the Obturator internus is derived from the dorsal nerve of penis or clitoris. 8) The pelvic splanchnic nerve of dogs originates from the ventral rami of the first, second and third sacral nerves and that of cats from the ventral rami of the first and second sacral nerves. 9) In the posterior femoral cutaneous nerve in dogs, as well as in rats and rabbits, the lateral deviation of the origin from the sciatic to the perineal nerve is observed.

Animals↗
PubMed1999

Female genital mutilation: the penultimate gender abuse.

OBJECTIVE: The five goals established for the development of this article were to: (1) provide an historical overview of the practice, (2) describe the procedure and its sequelae in realistic terms, (3) explore cultural justifications for the continuation of this action, (4) evaluate inherent moral/ethical/legal issues and, (5) focus worldwide professional attention on a gender-specific child atrocity. METHOD: A review of the past and current historical, popular and professional literature was undertaken to determine the precursors, magnitude, settings, rationale, and moral-ethical-legal-treatment issues associated with this mutilating procedure. RESULTS: Four forms of female genital mutilation were identified. These are: (1) sunna (removal of the prepuce of the clitoris); (2) clitoridectomy (removal of the prepuce and the clitoris); (3) excision (removal of the prepuce, clitoris, upper labia minora and perhaps the labia majora); and, (4) infibulation (removal of the prepuce, clitoris, labia minora, and labia majora). The "surgery" is performed most frequently by untrained midwives who use sharp rocks, razor blades, kitchen knives, broken glass, or even their teeth. As a rule, no anesthetics, antiseptics, analgesics or antibiotics are available to victims. Consequently, these females typically suffer from massive short-term and long-term physical, emotional, sexual and obstetrical sequelae. CONCLUSIONS: The justifications tendered by proponents do not withstand moral-legal-ethical scrutiny. Female genital mutilation is a violation of human rights and an atrocity perpetrated against helpless individuals who are unable to provide informed consent and who must therefore be protected through education and legislation.

Child↗
PubMed1985

Influence of age on steroid concentrations in skin and striated muscle in women and in cardiac muscle and lung tissue in men.

In order to investigate whether androgen concentrations vary as a function of age in all tissues and organs and whether the sexual differences in plasma androgen levels are reflected in tissue concentrations, testosterone (T), 5 alpha-androstane-17 beta-ol, 3-one (DHT), 5 alpha-androstane-3 alpha,17 beta-diol (Adiol), and 4-androstene-3,17-dione (Adion) concentrations were measured postmortem in lung tissue and myocardium of men aged 16-87 yr. The results were compared to values obtained previously in other tissues. Similar measurements were made in various tissues (labia majora, clitoris, pubic skin, thigh skin, striated muscle) from women aged 16-87 yr. In cardiac tissue of men, T was quantitatively the most important androgen and concentrations of DHT and Adiol were low, reflecting low 5 alpha-reductase activity; in lung tissue, T and Adion were found in similar concentrations, with lower levels of 5 alpha-reduced metabolites. In both cardiac and lung tissue, androgen concentrations decreased significantly with age. In women, androgen concentrations were highest in specific androgen target tissues (labia majora, clitoris) and lowest in thigh skin and striated muscle. The ratios of the 5 alpha-saturated metabolites (DHT plus Adiol) to T or to T + Adion, respectively, parallel total androgen concentrations, whereas the Adiol to DHT ratio, a parameter of 3 alpha-reductase activity, was highest in striated muscle and thigh skin and lowest in androgen target tissues (labia majora and clitoris). In women tissue concentrations of all androgens decreased significantly with age in nearly all tissues studied. As expected tissue androgen concentrations were lower in women than in men, but in androgen target tissues such as the clitoris or labia majora, concentrations were little lower than in scrotal skin. We conclude that in both men and women androgen target tissues contain high androgen concentrations and high 5 alpha-reductase activity; moreover androgen concentrations in target tissues are similar in both sexes. In both sexes tissue androgen concentrations decreased with age in most tissues, but in target tissues the decrease was more pronounced in women than in men.

Adolescent↗
PubMed1996

[Results of genitoplasty for virilized genitalia of 41 females with congenital adrenal hyperplasia].

OBJECTIVE: The results of genitoplasty performed at our clinic for 41 female patients with congenital adrenal hyperplasia (CAH) were reviewed. PATIENTS: Among 57 females with CAH (56 with 21-hydroxylase deficiency and 1 with 11 beta-hydroxylase deficiency) diagnosed between 1961 and 1995, 41 underwent genitoplasty. For the rest of 16 patients, 1 received already clitorectomy, 11 (19%) needed no surgical reconstruction, 2 died before surgery, and 2 are in a waiting list for surgery. RESULTS: According to Prader's classification of virilized genitalia, 41 patients who received surgery included 8 of type I, 10 of type II, 17 of type III, and 4 of type IV. There was no patients of type V, and 2 were not classified because of previous surgery. Four patients underwent genitoplasty 7 times in total before visiting us. The age receiving initial genitoplasty at our clinic ranged from one year and 9 months to 20 years (median: 4 years and 5 months). Follow-up period averaged 17 years with the range of 2 months to 33 years. For enlarged clitoris, clitorectomy (amputation of clitoris) was carried out for 22 patients before 1975 and corporal resection for 17 after 1975. Two patients manifested recurrence of clitoromegaly after the surgery because of either incomplete resection of the clitoris or patient's ignorance of taking glucocorticoid regularly. Thirty-six patients needed labiovaginoplasty. Simple midline cutback was performed for 6 patients and Y-V plasty (skin flap labiointroitoplasty) for 30. Vaginal orifice was not identified in 5 patients at the initial surgery. Two patients received successful second introitoplasty at the older age than 10. Post-operative stenosis of vaginal orifice was confirmed in 6 patients and 3 underwent second introitoplasty. Among 23 patients older than 25 years at present, 7 got married and 4 raised 6 children with assistance of Caesarian section. CONCLUSIONS: Most of female patients with CAH needed genital plastic surgery including clitoroplasty and labiovaginoplasty. Corporal resection for enlarged clitoris with sufficient hormone therapy brought a satisfactory result. Y-V plasty for labiovaginoplasty proved to be an excellent method, especially from cosmetic viewpoint, but remained some problems as one stage operation including difficult identification of vaginal orifice and post-operative stenosis of introitus in some patients.

Adrenal Hyperplasia, Congenital↗
PubMed1985

The external genitalia of female pygmy chimpanzees.

The external genitalia of four adult female pygmy chimpanzees (Pan paniscus) were examined during a 2-year period. It was found that the labia majora are retained in adults of this species and that, when tumescent, the labia minora effectively relocate the frenulum and clitoris so that they point anteriorly between the thighs. When detumescent, the configuration of the labia minora and clitoris resembles that of immature common chimpanzees (P. troglodytes). It is suggested that the simple, structural relocation of the clitoris from the normal condition noted in adult P. troglodytes makes possible the homosexual, intergenital rubbing observed in P. paniscus, when ventroventral juxtaposition of the individuals permits eye-to-eye contact. In addition, this change probably increases sexual stimulation of the female during heterosexual, ventroventral copulations. The possibility of intense, face-to-face sexual interactions has been achieved by P. paniscus without the evolution of bipedalism and the consequent reorientation of the genitalia seen in Homo sapiens.

Animals↗
PubMed2003

Dissociation between electrical and mechanical bulbocavernosus reflexes.

AIMS: To record reflex motor responses, elicited by mechanical stimulation of the penis or clitoris, in each bulbocavernosus muscles and to compare left and right reflex pathways in normal subjects, then to compare electrical and mechanical responses in various neurological diseases. METHODS: Two groups of patients were studied: 22 patients without neurological disease considered as normal subjects; and 25 patients with neurological disease (three multiple sclerosis, six spina bifida, nine conus medullaris syndrome, three peripheral neuropathies, two lumbosacral lesions, one multisystem atrophy, and one syringomyelia). Electrical bulbocavernosus reflex (EBCR) was evoked by orthodromic stimulation of the dorsal nerve of the penis at the penile base or the clitoris. Mechanical bulbocavernosus reflex (MBCR) was elicited with an electromechanical hammer, tapping directly on the clitoris zone or on the ventral part of glans penis. For EBCR and MBCR, bulbocavernosus muscle contractions were successively recorded in the left and in the right side with a needle inserted under visual guidance. RESULTS: Mean left mechanical latency was 31.7 msec (SD = 4.5) and right one 31.6 msec (SD = 3.8). The reproducibility of the responses was excellent (P < 0.0001). ). The mean difference between left and right latencies was 2 msec (SD = 1.2). In the neurological group, 22 EBCR (six right, nine left, seven bilateral) and 19 MBCR (eight right, nine left, two bilateral) were considered abnormal. The mean reflex latencies in patients with neurological lesions (lower motor neuron lesions) were statistically longer (P < 0.0001) than in normal subjects. Exact concordance (side of lesion) between MBCR and EBCR was observed in 15/25 cases (60%), poor concordance (presence of a sacral reflex alteration) in 3/25 (12%) cases, and in 7/25 (28%) cases there was a significant difference between the two techniques. CONCLUSIONS: MBCR may provide a good alternative for electrical stimulation and can be used to evaluate urinary disorders when a neurological etiology is suspected. However, the presence of false negatives with MBCR suggest that it may be more useful as a screening test.

Clitoris↗
PubMed1989

Surgical correction of virilised female external genitalia.

Recent investigations and reports on late results indicate that vaginal orgasm is more the exception than the rule, so that, for a woman, preservation of clitoral sensitivity is essential to a satisfying sexual life. All techniques involving total clitoridectomy, plastic imitations, or displacement of the clitoris under the symphysis must therefore be discarded. Even if plication or trapping of an enlarged clitoral shaft under the mons veneris can be regarded as sensitivity-maintaining procedures, they nevertheless do not yield satisfactory results, since painful sensations or a feeling of pressure may occur during erection. Hence, reduction-planess should use techniques which shorten the erectile parts of the clitoris and reduce its size, while still maintaining sensitivity. Good cosmetic and tactile results may be achieved by means of selective excision of the corpora cavernosa and lateral clitoral excisions. Reconstruction of the labia minora out of clitoral shaft skin is combined with separate creation of a neo-preputium clitoridis. Vaginal enlargement plasties have always been problematic, since shrinking particularly of the vaginal introitus, occurs in up to 25% of patients who undergo this operation. However, a sufficiently large pediculated perineal skin flap inserted into the "defect" of the posterior vaginal wall provides sufficient width of the vaginal introitus and canal. Partial vaginal aplasia, with the vagina opening into a urogenital sinus near the bladder, calls for additional abdominal mobilisation. For psychological reasons, vaginal dilatations are not to be recommended. If necessary, a second vaginal enlargement plasty should instead be performed later; this may be carried out without problems before puberty. To avoid the disadvantage of a dry skin flap which does not assimilate to normal vaginal mucosa even after many years and with oestrogen treatment, mobilisation of the posterior vaginal wall with displacement of real vaginal mucosa towards the perineum can be carried out. However, one-stage reconstruction of clitoris, vulva and vagina during early childhood is preferable in every case, in order to avoid the psychological damage which can undoubtedly otherwise be caused. An exception is the late onset form of congenital adrenal hyperplasia.

Adolescent↗
PubMed2001

Experimental models for the investigation of female sexual function and dysfunction.

There have been limited anatomic and physiological investigations of the female sexual arousal response. A broader understanding of the physiologic mechanisms of female sexual arousal function is required to improve the management of women with sexual dysfunction. Three experimental test systems have been developed to understand better the biochemical and physiological mechanisms of female sexual arousal response. An in vivo animal model was developed to record physiological and hemodynamic changes in the clitoris and vagina following pelvic nerve stimulation and administration of vasoactive agents and physiological modulators. In vitro organ baths of clitoral and vaginal tissue were utilized to investigate mechanisms involved in the regulation of smooth muscle contractility. In addition, primary cell cultures of human and animal clitoral and vaginal smooth muscle cells were developed to investigate signal transduction pathways modulating smooth muscle tone. In vivo studies revealed hemodynamic changes in vagina and clitoris in response to pelvic nerve stimulation, vasodilators and physiological modulators. Organ bath studies have demonstrated that clitoral and vaginal smooth muscle tone is affected by non-adrenergic and non-cholinergic neurotransmitters, and the presence of functional alpha 1 and alpha 2 adrenergic receptors in these tissues has been established through biochemical studies. These changes are regulated by the tone of vascular and non-vascular smooth muscle in the vagina and clitoris. Primary cell culture studies have suggested that several physiological modulators such as vasoactive intestinal polypeptide (VIP), nitric oxide (NO), and prostaglandin E (PGE) regulate vaginal smooth muscle contractility. Data from experimental models have provided a preliminary understanding of the mechanisms of the female sexual arousal response.

Animals↗
PubMed2003

Clitoral sensitivity after surgical correction in women with adrenogenital syndrome: a long term follow-up.

Surgical reduction of hypertrophy of the clitoris in early childhood, as well as vaginal reconstruction or vaginoplasty during the early teens, is required in girls with adrenogenital syndrome. In eight women (age >17 years) with adrenogenital syndrome, the sensitivity of the surgically reduced clitoris was evaluated by examination of vibration and light touch sensitivity, more than one year after vaginoplasty. When they were compared with a group of women who had not been operated on, the sensitivity to vibration and light touch were similar if the clitoris had been reduced as a one-stage procedure. In one woman who had had a second reduction, sensitivity was impaired. All women reported that the vaginal reconstruction was successful as far as sexual activity was concerned. Six of the eight had stable relationships with boyfriends or husbands. No pregnancies or children were reported.

Adolescent↗
PubMed2004

New techniques in female pudendal somatosensory evoked potential testing.

OBJECTIVE: The primary nerves innervating the female genitalia are the dorsal nerve of the clitoris (DNC) and the perineal nerve, which innervate the clitoris and the external genitalia/distal vagina, respectively. We describe two novel electrodiagnostic techniques for evaluating the integrity of these female genital somatosensory pathways. SUBJECTS AND METHODS: Seventy-seven healthy women (mean age 29.3 years) were enrolled for this study. We performed DNC somatosensory evoked potentials (SEPs), stimulating through self-adhesive disk electrodes on either side of the clitoris. Perineal nerve SEPs were evoked through a vaginal probe. Cortical responses were measured through cup electrodes affixed to the scalp at Cpz and Fpz. Stimulus parameters were duration 0.1 ms, frequency 4.1 Hz, filters 5-5,000 Hz, at three times sensory threshold. RESULTS: DNC and perineal nerve SEPs from both the right and left sides were reproducible and easily discerned. The mean P1 latencies were: right DNC 39.4 ms (SD 2.8 ms), left DNC 39.3 ms (SD 3.3 ms), right perineal nerve 37.8 ms (SD 3.4 ms), left perineal nerve 37.6 ms (SD 3.1 ms). We recorded SEP responses from 90 to 92% of subjects for the DNC, and 69% for the perineal nerve. CONCLUSIONS: We are able to evoke somatosensory potentials from the four primary somatic nerves that mediate female genital cutaneous sensation. In healthy subjects, the DNC responses are robust and maintain laterality. The perineal nerve responses are less consistently obtained, but when recorded, are easily discerned. These preliminary data provide a foundation from which to study female genital innervation, particularly as it applies to sexual function.

Adult↗
PubMed1997

Pattern and source of secretion of relaxin in the reproductive cycle of the spotted hyena (Crocuta crocuta).

Female spotted hyenas are highly masculinized at birth and have no external vagina. Copulation with males and birth of young are accomplished through the central urogenital canal of the clitoris. This unusual adaptation requires remarkable changes in the elasticity of the connective tissues of the clitoris, without which neither copulation nor birth would be possible. We hypothesized that relaxin, a hormone that increases the extensibility of the connective tissues of the uterus and cervix of many other mammalian species, plays a role in the clitoral changes observed in hyenas. Serum relaxin was determined by specific RIA. Relaxin was not detected in serum of males, pubertal or nonpregnant adult females, or ovariectomized females. Immunoactive relaxin was detected in serum of juveniles at the time of initial growth of the urogenital meatus. High concentrations of immunoactive relaxin appeared in the serum of pregnant hyenas in the 2 wk preceding parturition. Immunoassays of extracts of hyena tissues and serum obtained from uterine and ovarian veins indicated that the placenta was the predominant source of relaxin, with possible ovarian contributions. Circulating relaxin decreased promptly following cesarean section near term. We conclude that relaxin secretion coincides with changes in extensibility of clitoral connective tissues 1) during growth of the clitoris in juveniles and 2) near the time of parturition in adults.

Animals↗
PubMed2003

Metoidioplasty: a variant of phalloplasty in female transsexuals.

OBJECTIVE: To describe metoidioplasty, a technique for creating a neophallus from an enlarged clitoris in female transsexuals, without needing the complex, multi-staged surgical construction of a large phallus, as this reconstruction is one of the most difficult in female transsexuals. PATIENTS AND METHODS: From September 1995 to April 2002 metoidioplasty was used in 22 patients (aged 18-33 years). The technique is based on the repair of the most severe form of hypospadias and intersex. The 'urethral plate' and urethra are completely dissected from the clitoral corporeal bodies, then divided at the level of the glanular corona, and the clitoris straightened and lengthened. A longitudinal vascularized island flap is designed and harvested from the dorsal skin of the clitoris, transposed to the ventral side, tubularized and anastomosed with the native urethra. The new urethral meatus is brought to the top of the neophallus, and the skin of the neophallus and scrotum reconstructed using labia minora and majora flaps. RESULTS: The mean (range) follow-up was 3.9 (0.5-6) years; the neophallus was 5.7 (4-10) cm, considered satisfactory in 17 patients but the remaining five required additional phalloplasty. The complications were urethral stenosis in two and fistula in three patients. CONCLUSIONS: Metoidioplasty is an alternative to phalloplasty, allowing voiding while standing. In patients who desire a larger phallus, various techniques of phalloplasty can also be used.

Adolescent↗
PubMed1998

Androgens and masculinization of genitalia in the spotted hyaena (Crocuta crocuta). 1. Urogenital morphology and placental androgen production during fetal life.

According to common understanding of sexual differentiation, the formation and development of a penile clitoris in female spotted hyaenas requires the presence of naturally circulating androgens during fetal life. The purpose of the present study was to determine potential source(s) of such fetal androgens by investigating the timing of urogenital development and placental production of androgen during early and mid-gestation. Fetuses determined to be female by molecular techniques (lack of SRY gene) at days 33 and 48 of gestation had undifferentiated gonads, but the clitoris was already 'masculinized' and was generally similar to the phallus of a 50-day-old male fetus. Wolffian and Müllerian ducts terminated at the urogenital sinus in both sexes and a urethra was present along the entire length of the clitoris and penis. The adrenal gland was large and histologically differentiated at 33 days. Steroid gradients across the uterus (a drop in delta 4-androstenedione, with increases in oestrogen and androgen), and high androstenedione in ovarian veins indicated that ovarian androstenedione was metabolized and secreted as testosterone by the placenta throughout gestation. In vitro, whole or homogenized placentae at days 48 and 58 of gestation (110 days total) metabolized radiolabelled androstenedione into testosterone and oestradiol; the specific enzymatic activity of early placental tissues was higher than at later stages. A human placental homogenate had higher aromatase activity but did not produce testosterone unless aromatase was inhibited. Infusion of labelled androstenedione into the uterine arteries of hyaenas demonstrated the conversion of this substrate into testosterone and oestradiol and their secretion into the fetal circulation. Evidently, androgen is produced by the placenta and secreted into the fetal circulation from early in pregnancy when masculinization is first evident, before differentiation of the fetal ovary.

Androgens↗
PubMed1999

[A clinical study on virilization of external genitalia in congenital adrenal hyperplasia].

PURPOSE: In the newborn female with congenital adrenal hyperplasia (CAH), there are variable degrees of clitoral enlargement and virilization of the urethra. In order to investigate the factors that cause these variations, the degree of musculinization of the external genitalia in 44 patients with CAH was studied retrospectively. PATIENTS AND METHODS: This study includes a total of 44 patients with CAH aged 2 months to 12 years and 11 months old who had consulted Nagoya City University Hospital from 1977 to 1994. The length of clitoris on the first consultation was compared with the age and its change was followed. Also, the relationship among the length of clitoris on the first consultation, the degree of urethral virilization, the clinical forms i.e. salt-losing or simple-virilization, and the glucocorticoid hormonal condition were investigated with each other. In 5 pairs of sisters, the length of clitoris on the first consultation was compared within each pairs, and also the degree of urethral virilization was compared. RESULTS: The clitoral length on the first consultation was significantly correlated with the age (y = 1.8 x + 1.8, r = 0.7, p < 0.0001). The mean clitoral length at birth calculated from these data was 18 mm, which is as large as that of adult female one, and the clitoral enlargement rate was 1.8 mm/yr. The correlation was not clear between the clitoral length and the degree of urethral virilization, the clinical forms, and the glucocorticoid hormonal condition, either. On the other hand, the degree of urethral virilization was comparable within clitoral length was not comparable within them. CONCLUSIONS: The urethral virilization was suggested to be determined by the internal hormonal environment during embryonal stage which was shared by the each pair of sisters. On the Other hand, the clitoral length was depend on the patient's age though the factor which determined the length was not apparent. These facts indicated that, not only the severely musculinizing cases, but also the new born female with mildly virilizing urethra should be followed strictly not to undergo the clitoral enlargement.

Adrenal Hyperplasia, Congenital↗
PubMed1999

Formation of neoclitoris from glans penis by reduction glansplasty with preservation of neurovascular bundle in male-to-female gender surgery: functional and cosmetic outcome.

PURPOSE: During male-to-female gender reassignment surgery we used an abdominal pedicled inverted penile skin technique to create a vagina and extra folds of skin to create a clitoral hood. Although patients had orgasms with that technique, there was a general request for the placement of a sensate, erectile clitoris. Therefore, in 10 such patients undergoing transsexual surgery a neoclitoris was fashioned from the glans penis. Surgical technique and results are described. MATERIAL AND METHODS: From 1980 to 1995, 57 male-to-female gender surgeries were performed at our university center. In the last 10 such patients undergoing transsexual surgery a neoclitoris was created. Glans volume is reduced to match that of a normal size clitoris and the entire length of the dorsal neurovascular bundle is preserved. The neoclitoris is placed through a buttonhole in the newly constructed introitus. There was minimal bleeding from the bundle intraoperatively. RESULTS: In 8 of 10 patients the neoclitoris remained intact postoperatively with good sensation to touch, vibration and light pressure (sexual sensation). The cosmetic and functional appearance was that of a normal clitoris, and patients were satisfied. In 2 patients the results were not satisfactory because of necrosis of the neoclitoris. CONCLUSIONS: This technique has excellent functional and cosmetic results in the majority of patients. Preservation of the somatic, tactile and vibratory sensation of the neoclitoris is surgically practical, and can afford the patient the possibility of a more functional outcome of gender reassignment surgery.

Adult↗
PubMed2006

[Sulcus nervi dorsalis penis/clitoridis: clinical and forensic aspects].

Sulcus nervi dorsalis penis/clitoridis is a groove on inferior ramus of pubis and ventral surface of the body of pubis, where dorsal nerve of penis in male and dorsal nerve and artery of clitoris in female run. Close relation of the dorsal nerve of penis/clitoris and pubis, represented by the course of sulcus nervi dorsalis penis/clitoridis has a major impact in surgical disciplines. Exact preparation of the dorsal nerve of penis is crucial in correct performance of conversion of genitalia in patients with transsexualism, in reconstruction of posterior urethra, in hypospadia, during performance of penile blockade during circumcision and in revascularization surgery of erectile dysfunction. The role of sulcus nervi dorsalis penis in the Alcock's syndrome is discussed. Similarly, it is advisable to take care of the dorsal nerve of clitoris inside sulcus nervi dorsalis clitoridis during reduction clitoridoplasty in patients with adrenogenital syndrome and during the insertion of transobturator vaginal tape. Injury of dorsal nerve of penis/clitoridis leads to hypestesia or anestesia of glans penis/clitoridis. The injury of dorsal artery of clitoris leads to hematoma. It is possible to use sulcus nervi dorsalis penis/clitoridis in sexing of isolated pubis from antropological or forensic purposes. Lateral border of sulcus nervi dorsalis penis/clitoridis corresponds to vertical ridge and lateral border of sulcus nervi dorsalis clitoridis to ventral arc--two parameters, which are part of the Phenice's method for sexing of isolated pubis.

Clitoris↗
PubMed1986

[Clitoral massage as a supporting measure in manipulation of the bovine uterus].

A method of exciting the clitoris is described. After such a massage or stimulation of the clitoris, the cervix lumen enlarges and allows an easier passage. Thus one can assume that a reflex arc exists. Directions on how to arouse the "clitoris-cervix-reflex" can be requested by sending an international self addressed stamped envelope to the author.

Animals↗
PubMed1999

Early clitoral carcinoma successfully treated by radiotherapy and bilateral inguinal lymphadenectomy.

A 42 year-old female presented with an early stage IB squamous cell carcinoma involving the clitoris. She was treated with radical radiotherapy to the clitoris and peri-clitoral region and bilateral inguinal lymphadenectomy. The treatment was well tolerated. The vulvar appearance, sensation and orgasmic function have not been impaired. There has been no recurrence during five years of follow-up. Radiotherapy and bilateral inguinal lymphadenectomy are an effective therapeutic option in early stage IB carcinoma involving the clitoris in sexually active females.

Journal Article↗