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At least 307 records · Page 17Linked to original sources
PubMed1993

Bilateral gonadoblastoma in a 9-month-old infant with 46,XY gonadal dysgenesis.

A 9-month-old infant with hypertrophic clitoris and separated urethral and vaginal opening was diagnosed as having 46,XY incomplete "pure gonadal dysgenesis". Examination of both gonads revealed gonadoblastoma and bilateral salpingo-gonadectomy and partial hysterectomy were performed. Patient is raised as a girl, and clitoroplasty will be done in next several months. The fact that gonadal neoplasia in our patient was found already at the age of 9 months, confirms the need for gonadectomy at the time of diagnosis in the patients with 46,XY gonadal dysgenesis.

Clitoris↗
PubMed2006

Physioanatomical relationship of the external anal sphincter to the bulbocavernosus muscle in the female.

Both external anal sphincter (EAS) and bulbocavernosus muscle (BCM) have been shown anatomically and physiologically to constitute one muscle in males. We investigated the hypothesis that the EAS and BCM have similar anatomical pattern in females. The study consisted of cadaveric dissection, electromyographic recordings and inferior rectal nerve stimulation. Bulbocavernosus reflex action was performed in 16 healthy women before and after anesthetization of the EAS and BCM. The EAS extended forward across the perineal body and became continuous with the BCM in the labia majora. Glans clitoris (GC) or inferior rectal nerve stimulation effected synchronous EAS and BCM contractions with identical action potentials. GC stimulation while the EAS or BCM was anesthetized produced neither EAS nor BCM response. Similarly, stimulation of the anesthetized GC produced no EAS or BCM response. The BCM and EAS apparently constitute a single muscle, which seems to play dual and yet synchronous roles in fecal control and sexual response.

Adult↗
PubMed2002

Effects of estrogen on the relaxation response of rabbit clitoral cavernous smooth muscles.

We investigated whether estrogen has a peripheral effect on the smooth muscle relaxation response of the clitoris, similar to that of androgens in cavernous tissues of the penis. Forty-two New Zealand White female rabbits (2.3-2.7 kg) were randomly divided into control (sham operation) and bilateral oophorectomy groups (acute and chronic groups with or without estradiol replacement). The acute and chronic groups were killed at 5 days and 12 weeks post-oophorectomy, respectively. Relaxation responses of the clitoral cavernous strips to endothelium-dependent and independent vasodilators and electrical field stimulation (EFS) were observed. Serum total cholesterol and low-density lipoprotein increased significantly and acetylcholine-induced relaxation of the clitoral strips wa significantly attenuated in the oophorectomy group with chronic estrogen deficiency but not in the chronic oophorectomy group with estradiol replacement or in the acute estrogen deficiency group. No significant differences in the relaxation responses of the cavernous strips to sodium nitroprusside or to the non-adrenergic, non-cholinergic-selective relaxation response to the EFS were found among the control, acute and chronic estrogen deficiency groups. These findings suggest that estrogen may not have a direct peripheral effect on clitoral cavernous smooth muscle relaxation. Hypercholesterolemia might be a possible explanation for the impaired endothelium-dependent relaxation of clitoral smooth muscle in chronic estrogen deficiency.

Animals↗
PubMed2001

The effect of estrogen-replacement therapy on clitoral-cavernosal tissue in oophorectomized rats: a histo-quantitative study by image analyzer.

Sexual dysfunction is an important problem for aging females. However, little attention has been paid to female sexual dysfunction. The clitoris is an important organ for physiological sexual function in females. There is a close relationship between the presence of sexual complaints and levels of estrogen. Using the rat as an experimental model, we evaluated the effect of estrogen-replacement therapy and its timing on clitoral-cavernosal collogen fiber content after oophorectomy. Four-month-old female Wistar rats (n = 36) weighing 230-250 g were used. They were categorized into four groups: oophorectomized (Group 1: n = 10); oophorectomized delayed estrogen replacement (group 2: n = 10); oophorectomized + immediate estrogen replacement (group 3: n = 10); and sham operated (group 4: n = 6). The estrogen replacement used was 17-beta-estradiol. All rats were euthanized at the same age. The specimens were stained with Masson's trichome technique, and computerized image analysis was used to quantify the collagen-fiber content of clitoral-cavernous tissue. The clitoral collagen-fiber percentages in the different groups were as follows: group 1: 64.17 +/- 5.01%; group 2: 62.57 +/- 5.37%; group 3: 56.33 +/- 3.85%; group 4: 51.48 +/- 6.37%, respectively. Although there was a tendency in the untreated group for a higher collagen-fiber content, no statistically significant difference was found among groups (P > 0.05). Although the results of this study were not statistically significant, estrogen did appear to decrease clitoral-cavernosal collagen-fiber content. These findings may be important in the pathophysiology of postmenopausal female sexual dysfunction.

Animals↗
PubMed1999

Complete duplication of bladder and urethra in the coronal plane in a girl: case report and review of the literature.

An unusual case of complete duplication of the bladder and urethra in the coronal plane associated with left ectopic kidney, duplication of the clitoris and a chondrolipomatous malformation in the pelvic region in a girl is reported. The accessory bladder was located posterolateral to the normal bladder and a ureteric opening into the accessory bladder was found. The malformation was initially identified by US and cystography and confirmed by cystoscopy.

Abnormalities, Multiple↗
PubMed2002

The role of mechanical devices in treating female sexual dysfunction and enhancing the female sexual response.

Female sexual dysfunction (FSD) is a common medical problem estimated to affect about 40 million American women. In 1998, the American Foundation of Urologic Disease (AFUD) Consensus Panel classified FSD into four different categories: sexual desire disorder, sexual arousal disorder, orgasmic disorder, and sexual pain disorder. This article will focus on the role of mechanical devices to treat sexual arousal and orgasm disorders and to enhance the female sexual response. Mechanical devices may work through vibratory stimulation or by causing clitoral vascular engorgement using a vacuum system. While a number of vibratory stimulating devices are available, only one U.S. Food and Drug Administration cleared-to-market device is available by prescription to treat FSD, the Eros Therapy device (UroMetrics, Inc., St. Paul, Minn., USA). The Eros Therapy is a small, battery-powered device used to gently apply direct vacuum over the clitoris causing the clitoral erectile chambers and labia to fill with blood. This article will review the rationale and benefits of using mechanical devices to treat FSD.

Clitoris↗
PubMed1999

Covered exstrophy with incomplete duplication of the bladder.

A rare exstrophy variant in a 1(1/2)-year-old girl is reported. The child had a wide, scar-like lesion over the lower central abdomen with divarication of the recti and a spread symphysis pubis. The underlying bladder was divided into two unequal chambers by a complete sagittal septum with only the right chamber communicating with the single urethra and the left draining by a vesicocutaneous fistula. Both kidneys were normal. The clitoris was bifid and the anus anteriorly placed. Preliminary surgical management consisted of dissection of the bladder from its prevesical covering, excision of the sagittal septum, and cystocystostomy. Postoperatively, the child had normal urinary continence. The literature is reviewed with special reference to the various forms of duplicate exstrophy.

Abnormalities, Multiple↗
PubMed2000

Hydrops of placental stem villi complicated with fetal congenital adrenal hyperplasia.

The authors present a case report of hydrops of placental stem villi. Numerous small aechoic spaces were demonstrated by prenatal ultrasonography. The patient spontaneously delivered a female newborn at 26 weeks' gestation. The infant showed hypertrophied clitoris and urogenital sius, and had a normal 46, XX karyotype. Endocrinological examination revealed that 3beta-hydroxysteroid dehydrogenase deficiency caused the anomaly. To our knowledge, this is the first report that congenital genital malformation complicated the placental mesenchymal dysplasia.

3-Hydroxysteroid Dehydrogenases↗
PubMed2004

Clitoral metastasis from transitional cell carcinoma of the renal pelvis: CT and MRI findings.

Metastatic tumors of the clitoris are extremely rare. We report a case of clitoral metastasis in a 75-year-old woman who was treated for transitional cell carcinoma of renal pelvis 2 years ago. The computed tomography and magnetic resonance imaging findings are presented with a short review of the literature. To the best of our knowledge, clitoral metastasis originating from transitional cell carcinoma of the renal pelvis has not been reported in the English language literature.

Aged↗
PubMed1990

Urethral duplication with single bladder and multiple genitourinary abnormalities: an example of continent urinary diversion.

A 13-year-old girl with multiple genitourinary malformations, incomplete bladder exstrophy, urethral duplication with single bladder, septate vagina, and total urinary incontinence is presented. Prior to admission she had undergone surgery for teratoma and calculi of the bladder and partial fecal incontinence. A continent urinary diversion was done by bladder augmentation using a cecal-colonic segment and by surgical closure of the bladder neck. The distal end of the appendix was brought to the skin as an inconspicuous, easily catheterizable, watertight stoma, our modification of the Mitrofanoff procedure. Excision of the vaginal septum, creation of an introitus, and unification of the split clitoris improved the cosmetic appearance of the external genitalia and improved the outlook for a normal sexual life and pregnancy.

Abnormalities, Multiple↗
PubMed1992

Functional results in young women having clitoral reconstruction as infants.

Nine young women who had clitoral recession for clitoromegaly as infants have been evaluated for anatomical appearance, psychosocial adjustment, and sexual function. Highly satisfactory anatomic results were obtained, although two patients required subsequent revision. The tested psychological parameters were essentially normal. Virtually all patients were sexually active and all but one have achieved regular painless orgasm. Surgical reconstruction has been accomplished by recessing the entire disfigured clitoris, thereby conserving all erectile tissue and preserving sensation. In addition to assessment of anatomical appearance, long-term follow-up of children with ambiguous genitalia requires regular evaluation of social, psychological, and sexual parameters.

Adolescent↗
PubMed1991

Hypertrophy of clitoral hood: presenting sign of neurofibromatosis in female child.

Although clitoral involvement with neurofibromatosis is rare, all cases previously reported have described clitoral hypertrophy due to neurofibromas of the clitoral corpora. We report on a patient who had localized enlargement of the prepuce only, with no evidence of neurofibromatous infiltration. In all cases, diagnosis of clitoromegaly requires basic chromosomal and endocrinologic evaluation. However, recognition of its association with neurofibromatosis due to either neurofibromas of the genitalia or localized genital hypertrophy may spare the patient an unnecessary or invasive evaluation. Because of an association with urinary tract neurofibromas, the patient with genital involvement should have cystoscopy. Clitoroplasty with sparing of the neurovascular bundle and glans is the preferred method of management of the enlarged clitoris.

Child, Preschool↗
PubMedDate not supplied

Pudendal SEP and bulbocavernosus reflex in women.

A new simple method for the electrical stimulation of the dorsal nerve of clitoris is presented. Well-formed cortical somatosensory evoked potentials could be recorded in 12 continent adult females without nervous system involvement at a stimulus intensity of 4 times 'sensory threshold.' The procedure was well tolerated by the subjects; the bulbocavernosus reflex responses were, however, not always obtainable at this stimulus intensity.

Adolescent↗
PubMed1981

Primary afferent and sacral dorsal horn neuron responses to vaginal probing in the cat.

An analysis was made of primary afferent and dorsal horn neuron responses to stimulation of genitalia of female cats. Three types of primary afferents responded to vaginal probing. The most common type responded maximally to the on- and off-ramps of non-noxious pressure applied directly to the clitoris. A second type responded similar but to surrounding labia mucosa. The third type showed a tonic discharge during deep vaginal-cervical probing. None of the primary afferents that responded to vaginal probing exhibited after-responses to any stimulus. However, a majority (76%) of wide dynamic range dorsal horn neurons showed increased rates of firing that outlasted the duration of vaginal probing by at least 28 sec. No other type of dorsal horn neuron responded in this manner. It appears that after-responses of wide dynamic range neurons to vaginal stimulation cannot be attributed to after-responses of primary afferents or to supraspinal mechanisms but are produced by mechanisms within the spinal cord.

Animals↗
PubMed2005

Evaluation of the role of pudendal nerve integrity in female sexual function using noninvasive techniques.

OBJECTIVE: Using quantitative sensory testing and a validated questionnaire, we investigated the role of pudendal nerve integrity in sexual function among women. STUDY DESIGN: Participants completed the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ). Vibratory and pressure thresholds were measured at the S2 dermatome reflecting pudendal nerve distribution. RESULTS: A total of 56 women enrolled; 29 (51.8%) were asymptomatic and 27 (48.2%) had 1 or more forms of female sexual dysfunction (total sexual dysfunction) including: desire disorder 16.1%, arousal disorder 26.8%, orgasmic disorder 25%, and pain disorder 12.5%. Age, parity, menopausal status, and body mass index were similar between groups. PISQ scores were lower in symptomatic subjects compared with controls (P < .001). Decreased tactile sensation was found at the clitoris for women with total sexual dysfunction, desire disorder, and arousal disorder. Women with arousal disorder also had decreased tactile sensation at the perineum. CONCLUSION: Pudendal nerve integrity may play a role in female sexual dysfunction.

Adult↗
PubMed2005

Does hysterectomy affect genital sensation?

OBJECTIVES: To evaluate vaginal and clitoral sensation before and after hysterectomy and to assess pre- and post-surgery changes in sexual function. STUDY DESIGN: Quantitative sensory thresholds for warm, cold, and vibratory sensations were measured at the vagina and clitoris 1 day prior to and 3 months following surgery. A survey was performed 18 months following operation to evaluate long-term changes in sexual function. PARTICIPANTS: Twenty-seven women, aged 30-57 years, who were admitted for elective hysterectomy. MAIN OUTCOME MEASURES: Genital sensation and reported sexual function. RESULTS: There was significant deterioration in sensation to cold and warm stimuli at the anterior and posterior vaginal wall after surgery. Vaginal vibratory sensation thresholds tended to increase. Clitoral thermal and vibratory sensation thresholds remained unchanged before and after surgery. Of the 22 patients who participated in the follow-up survey, 17 did not report any decline in sexual function, while 4 patients reported deterioration in genital sensation and in sexual function. CONCLUSION: The results demonstrate quantifiable sensory loss in the vagina after hysterectomy, with preservation of clitoral sensation. Only a minority of patients reported a decline in their sexual function. These findings highlight the relative importance of clitoral as compared to vaginal sensation in sexual function.

Adult↗
PubMed2006

Sulcus nervi dorsalis penis/clitoridis: anatomic structure and clinical significance.

OBJECTIVES: The aim of this study was to correlate the anatomic and clinical significance of the prepubic course of dorsal nerve of penis and its groove on the pubic bone from the perspective of the surgeon. METHODS: The course of the dorsal nerve of the penis/clitoris was studied in six male and six female formalin-fixed cadavers. Several parameters of the pubis were quantified and analysed in 286 isolated pelvises. RESULTS: The course of the dorsal nerve of the penis is described in detail. This pubic sulcus was present in a majority of the pelvises examined. The dorsal nerve of the penis filled this groove, which we term the "sulcus nervi dorsalis penis/clitoridis." In contrast, the dorsal nerve and artery of the clitoris coursed in this groove in women. CONCLUSIONS: The course of dorsal nerve of the penis is described in detail including a previously unreported pubic structure-"sulcus nervi dorsalis penis/clitoridis." In the majority of individuals, the dorsal nerve of the penis/clitoris courses through the sulcus in the pubis. Based on the anatomy of the pelvic region, compression of the dorsal nerve is more apt to occur at the inferior border of the pubis or in the pubic sulcus than in the pudendal canal.

Aged↗
PubMed2006

Estradiol-associated variation in responses of rostral medullary neurons to somatovisceral stimulation.

The lordosis posture and cervix stimulation during copulation are important reproductive events involving complex neural circuitries that are under hormonal influence. An important component of this circuitry, neurons within the medullary reticular formation (MRF), was examined in the present study using electrophysiological techniques. Single unit extracellular recordings were performed in the MRF of 27 urethane-anesthetized female rats. Using bilateral electrical stimulation of the dorsal nerve of the clitoris as the search stimulus, a detailed examination of the somatovisceral convergent responses of 585 individual MRF neurons was made. A total of 7 different groups of cycling and ovariectomized/hormone-supplemented rats were examined and their neuronal response properties to mechanical stimulation of various pelvic organs (cervix pressure, vaginal distension, colon distension) compared. The results indicate the existence of complex response properties as well as several variations in MRF response characteristics that are hormone-dependent. Specifically, estradiol is associated with hyposensitivity to cervix pressure and hypersensitivity to stroking the face. These opposing effects of estradiol in the same subset of neurons likely relate to lordosis behavior which can be either disrupted or elicited, depending on the area being stimulated (upper versus lower parts of the body, respectively).

Animals↗