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• W2128555222 abstract "No AccessJournal of UrologyReview Articles1 Oct 2005ANATOMY OF THE CLITORIS HELEN E. O'CONNELL, KALAVAMPARA V. SANJEEVAN, and JOHN M. HUTSON HELEN E. O'CONNELLHELEN E. O'CONNELL More articles by this author , KALAVAMPARA V. SANJEEVANKALAVAMPARA V. SANJEEVAN More articles by this author , and JOHN M. HUTSONJOHN M. HUTSON More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000173639.38898.cdAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We present a comprehensive account of clitoral anatomy, including its component structures, neurovascular supply, relationship to adjacent structures (the urethra, vagina and vestibular glands, and connective tissue supports), histology and immunohistochemistry. We related recent anatomical findings to the historical literature to determine when data on accurate anatomy became available. Materials and Methods: An extensive review of the current and historical literature was done. The studies reviewed included dissection and microdissection, magnetic resonance imaging (MRI), 3-dimensional sectional anatomy reconstruction, histology and immunohistochemical studies. Results: The clitoris is a multiplanar structure with a broad attachment to the pubic arch and via extensive supporting tissue to the mons pubis and labia. Centrally it is attached to the urethra and vagina. Its components include the erectile bodies (paired bulbs and paired corpora, which are continuous with the crura) and the glans clitoris. The glans is a midline, densely neural, nonerectile structure that is the only external manifestation of the clitoris. All other components are composed of erectile tissue with the composition of the bulbar erectile tissue differing from that of the corpora. The clitoral and perineal neurovascular bundles are large, paired terminations of the pudendal neurovascular bundles. The clitoral neurovascular bundles ascend along the ischiopubic rami to meet each other and pass along the superior surface of the clitoral body supplying the clitoris. The neural trunks pass largely intact into the glans. These nerves are at least 2 mm in diameter even in infancy. The cavernous or autonomic neural anatomy is microscopic and difficult to define consistently. MRI complements dissection studies and clarifies the anatomy. Clitoral pharmacology and histology appears to parallel those of penile tissue, although the clinical impact is vastly different. Conclusions: Typical textbook descriptions of the clitoris lack detail and include inaccuracies. It is impossible to convey clitoral anatomy in a single diagram showing only 1 plane, as is typically provided in textbooks, which reveal it as a flat structure. MRI provides a multiplanar representation of clitoral anatomy in the live state, which is a major advantage, and complements dissection materials. The work of Kobelt in the early 19th century provides a most comprehensive and accurate description of clitoral anatomy, and modern study provides objective images and few novel findings. The bulbs appear to be part of the clitoris. They are spongy in character and in continuity with the other parts of the clitoris. The distal urethra and vagina are intimately related structures, although they are not erectile in character. They form a tissue cluster with the clitoris. This cluster appears to be the locus of female sexual function and orgasm. References 1 : Last's Anatomy. Regional and Applied. Edinburgh: Churchill Livingstone1999: 298. Google Scholar 2 : Gray's Anatomy. New York: Churchill Livingstone1995. Google Scholar 3 : Atlas of Urosurgical Anatomy.. Philadelphia: W. B. Saunders Co.1993: 389. Google Scholar 4 : Human Sexual Response.. 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Cambridge, Massachusetts: Harvard University Press1990: 313. Google Scholar From the Department of Urology, Royal Melbourne Hospital, Victoria, Australia© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byBenz K, Dunn E, Solaiyappan M, Maruf M, Kasprenski M, Jayman J, Michaud J, Facciola J, DiCarlo H and Gearhart J (2018) Novel Observations of Female Genital Anatomy in Classic Bladder Exstrophy Using 3-Dimensional Magnetic Resonance Imaging ReconstructionJournal of Urology, VOL. 200, NO. 4, (882-889), Online publication date: 1-Oct-2018.Poppas D, Hochsztein A, Baergen R, Loyd E, Chen J and Felsen D (2007) Nerve Sparing Ventral Clitoroplasty Preserves Dorsal Nerves in Congenital Adrenal HyperplasiaJournal of Urology, VOL. 178, NO. 4S, (1802-1806), Online publication date: 1-Oct-2007. Volume 174Issue 4 Part 1October 2005Page: 1189-1195 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsanatomy and histologymagnetic resonance imaginggenitalia, femaleclitorishistory of medicineMetricsAuthor Information HELEN E. O'CONNELL More articles by this author KALAVAMPARA V. SANJEEVAN More articles by this author JOHN M. HUTSON More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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