DOCSLIB.ORG

Vestibular Bulb Hypertrophy

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

Bahar 1367 Medical Journal of Th� Sh,lahan l..j.()� l;lamic Rcpuhlic of Iran �pnng 19:-;;-; VESTIBULAR BULB HYPERTROPHY H. DABIRASHRAFI,M.H. KARIMINE1AD.Y. BEH1ATNIA, AND N. MOGHDAMI TABRIZI Fromlhe [)eI'{{r/I1l(,lll 0/( )/J.I/e[riCl alld Gynccologv, MirzaKOllchek Khan (Zanan) Hospital. Tehran University of Medical Sciences, Tehran, Islamic Republic of fran ABSTRACT In this case report, a 36 year old female at 40 weeks' gestation is presented in whom large bilateral vestibular bulb masses were found on pelvic examination. The size of the masses was such as to cause concern that they may pose an impediment to normal parturition. Our pathological findings, management and results are presented. MllRI, Vol.2, No.1, 71-73,1988 INTRODUCTION Although cysts of the vagina and vulva are seen rather frequently. only on exceptional occasions does one encounter them in pregnant women and of a sufficient size to interfere with delivery. Spitzer' reported a very interesting and unusual case in which a cyst of Gartner's duct caused a face presenta­ tion. A more common conditiOli is an abscess of the Bartholin gland.' Venereal warts (condylomata) may reach a large size in pregnancy. but seldom to the extent of causing an obstruction.' We report a case of vestibu­ lar bulb tumors that raised concern in that they may obstruct delivery. Downloaded from mjiri.iums.ac.ir at 23:57 IRST on Thursday September 30th 2021 CASE REPORT t A36 year old white woman. G = 7. P = 6. Ah = ()was admitted to the hospital in active true lahor at 4() weeks of gestation. Her past history was unremarkable. Vaginal examination and a glance at the vestibular area revealed two large tumoral cystic masses,on either side of the introitus. These two tumors hecame enlarged during bearinu down. closing the entrance of the �aginal c;�nal., anZl they decreased in size after cessaton of uterine contrac· tion. The tumors were located bilaterally near the labIa minora in the vestibular alt:d at the beginn[ng of the lateral walls of the vagina. The d1mcnsIOns of the tuInO rs were 7x4x3 cm on the rightL and 5x4x3 cm on the left (Fig, I). With due caution. delivery was performed without Figure 1. Two ovoid milSS':S hulging hibtc ralh intn tilL' ,'cstihular complication. although a major concern was that the area of the vagina. 71 Vestibular Bulb Hypertrophy Figure 2, Thick-wallcd \'cs,,:ls an: pflll11inl'nt. NoLL'tile: �all�lioll celb in the upper ri�ht corncr (H & E. ori�inall11a�nirication X'+)), ',' yT • f • ..:;,. .. �. ". .., , ,,, '. \ • • .... .. , ';� 10 'oot • l" , •• " ' I ". .. tI' " . Downloaded from mjiri.iums.ac.ir at 23:57 IRST on Thursday September 30th 2021 30th September Thursday on IRST 23:57 at mjiri.iums.ac.ir from Downloaded , .- tt . ' - . , ., , " .' l, , , . " , ..� .. ti t , ... ..., <# , .... - -, , .. , , • • II I " -.. J , -/ J 72 tumors might obstruct the delivery or he crushed by the two ovoid masses of erectile tissue. much thicker passage of the fetal head. After delivery 10 lU of po,steriorly. They are comparahle to the hulh of the oxytocin was injected intramuscularly. penis in the male and comprise of a rich plexus of veins. 7 days after delivery. when the tumors became The microscopic characteristics and hilaterality of smaller (5x3x2 cm. on the right and 4x2x2 cm. on the the tumors in our patient indicate that in reality. these left). they were removed under general anaesthesia. tumors were vestibular hulh aberrations that increased Two days postoperatively. the patient was discharged in size and changed location (Fig. I). At the time of from the hospital in good health. Since that time. the delivery, our concern was that the tumors seemed to be patient has heen examined on sever,11 occasions and has rich in hlood vessels and might be crushed. producing a no complaints. hematoma. But fortunately. delivery was completed successfully without complications. Seven days after Pathology delivery the masses hccame smaller hut still were of The hIstological sections of right and left-side speci­ ahnormal size. Excision of the tumors revealed the mens reveal a very thick-walled vascular channel lined microscopic appearance of Grectile tissLic compatible by a layer of endothelial cells. The vascular wall with vestibular hulb structures. To the authors' know­ consists of smooth muscle hundles. arranged longitudi­ ledge. this is the first report of vestibular bulh hyperh'o nally along the vascular axis. Elastic fihers surround the phy during prcgnancy that raised concern as to their muscle bundles and form thick hands in some areas. obstruction of delivery. Nerve fibers and ganglion cells are scattered through­ out. The histological features are similar to corpus spongiosum of male external genitalia (Figs. 2-3). REFERENCES I. Myerscough PRe Munro Kerr's Orerative Ohstetrics. London. DISCUSSION flallicrc Tindall. IKJ-4. I YX2. 2. Prilchard .lA. MacDonald Pc. Gant NF: Dystocia from other The vestibule may be defined as the portion of the abnormalities of thc reproductivc tract. In: Pritchard .lA. Mac­ vulva which begins at the hymenal ring and extends Donald PC, Ganl NF, eds. Williams' Obstetrics, Norwalk. Appleton-Century Crofts. (,X7-fW;. IWi.'i. outward to blend with the more keratinized skin of the .'1. Woodruff .lD. Fricdrich EG.lr: Thevestihule. ('lin Obstet Gynccol minor labia, upward to the frenulum of the clitoris. and �X (I): 134-41. 19X.'i. downward to include the posterior fourchette. On 4. Rohhov S.I. Foss .IS. Prat.l. Kch Pc. Welch WR: Urogenital SillliS either side of the vestibule there are two structures that nrigin or mucinous and ciliated cysts or Ihc vulva. Obstet Gvnecol are called "vestibular bulbs". These organs consist of 51 (.I): .'147-SI. 197f1. Downloaded from mjiri.iums.ac.ir at 23:57 IRST on Thursday September 30th 2021 73 Downloaded from mjiri.iums.ac.ir at 23:57 IRST on Thursday September 30th 2021.
Recommended publications
  • The Cyclist's Vulva

    The Cyclist's Vulva

    The Cyclist’s Vulva Dr. Chimsom T. Oleka, MD FACOG Board Certified OBGYN Fellowship Trained Pediatric and Adolescent Gynecologist National Medical Network –USOPC Houston, TX DEPARTMENT NAME DISCLOSURES None [email protected] DEPARTMENT NAME PRONOUNS The use of “female” and “woman” in this talk, as well as in the highlighted studies refer to cis gender females with vulvas DEPARTMENT NAME GOALS To highlight an issue To discuss why this issue matters To inspire future research and exploration To normalize the conversation DEPARTMENT NAME The consensus is that when you first start cycling on your good‐as‐new, unbruised foof, it is going to hurt. After a “breaking‐in” period, the pain‐to‐numbness ratio becomes favourable. As long as you protect against infection, wear padded shorts with a generous layer of chamois cream, no underwear and make regular offerings to the ingrown hair goddess, things are manageable. This is wrong. Hannah Dines British T2 trike rider who competed at the 2016 Summer Paralympics DEPARTMENT NAME MY INTRODUCTION TO CYCLING Childhood Adolescence Adult Life DEPARTMENT NAME THE CYCLIST’S VULVA The Issue Vulva Anatomy Vulva Trauma Prevention DEPARTMENT NAME CYCLING HAS POSITIVE BENEFITS Popular Means of Exercise Has gained popularity among Ideal nonimpact women in the past aerobic exercise decade Increases Lowers all cause cardiorespiratory mortality risks fitness DEPARTMENT NAME Hermans TJN, Wijn RPWF, Winkens B, et al. Urogenital and Sexual complaints in female club cyclists‐a cross‐sectional study. J Sex Med 2016 CYCLING ALSO PREDISPOSES TO VULVAR TRAUMA • Significant decreases in pudendal nerve sensory function in women cyclists • Similar to men, women cyclists suffer from compression injuries that compromise normal function of the main neurovascular bundle of the vulva • Buller et al.
  • Anatomy and Physiology of Erection: Pathophysiology of Erectile Dysfunction

    Anatomy and Physiology of Erection: Pathophysiology of Erectile Dysfunction

    International Journal of Impotence Research (2003) 15, Suppl 7, S5–S8 & 2003 Nature Publishing Group All rights reserved 0955-9930/03 $25.00 www.nature.com/ijir Chapter 2 Anatomy and Physiology of erection: pathophysiology of erectile dysfunction Reporters and participants of the 1st Latin American Dysfunction Consensus Meeting International Journal of Impotence Research (2003) 15, Suppl 7, S5–S8. doi:10.1038/sj.ijir.3901127 Anatomy deep dorsal vein, the circumflex veins, the emissary veins, the cavernous veins and the crural veins). The lacunar spaces drain into small venules, which flow The penis, the male genital organ, has two func- together into a subalbugineal plexus, which in turn, tions: sexual and urinary. It is located above the emerges as emissary veins4,5 (Figure 1). scrotum, and it is linked to the pubic symphysis by two ligaments. It has a three-cylinder shape, integrated by two CROSS-SECTIONAL SECTION OF THE PENIS vascular tissue bodies (corpora cavernosa) (CC) and Superficial dorsal vein the corpus spongiosum (CS). The CCs have two Dorsal artery of penis Dorsal nerve of portions: a fixed posterior one, or perineal, and one penis that is anterior or free. At its base, the ischiopubic Deep dorsal vein Colles’ fascia rami are fixed, surrounded by the ischiocavernous muscles. The CS, in turn, stems from the perineum, Buck’s fascia Circumflex Vein surrounded by the bulbocavernous muscle. The Corpus urethra runs most of its length. At the distal end, cavernosum Tunica albuginea the CS dilates into a structure known as glans, Cavernous artery where the urethra opens to the outside of the Corpus spongiosum Urethral artery body through the meatus.1,2 Urethra Adapted and Modified from the 2ndBrazilian Consensus on Erectile Dysfunction2 The penis has an epidermal layer, underneath which is located the superficial fascia (Colles’), Figure 1 Cross-sectional section of the penis.
  • A Guide to Clitoral

    A Guide to Clitoral

    A guide to clitoral sex Text Sandra Dahlén English translation Tom Ellett for Exacta översättningar AB Layout and illustrations Eva Fallström Cover photo Maria Gullmark Tryckeri EO Grafiska december 2008 ISBN 978-91-85188-36-9 rfsu • a guide to clitoral sex The clitoris Many people, both scientists and individuals, proud- ly claim to have ‘‘discovered’’ the clitoris. For a long time, the clitoris seems to have been regarded as the principal and most obvious female sex organ, but at some point in the 19th century this focus on the clitoris disappeared in favour of the vagina. Female sexuality was increasingly associated with child-bea- ring, and the clitoris was largely obliterated from the sexual map. In 1905, however, the clitoris was offi- cially ‘‘rediscovered’’ by Sigmund Freud. Freud also put the female orgasm back under the spotlight, be- lieving there were two kinds of orgasm: clitoral and vaginal. The vaginal orgasm, in Freud’s view, was the ‘‘mature’’ and desirable kind. Since the mid 20th cen- tury researchers and activists, mainly from the Uni- ted States and Australia, have been working to gain • • rfsu • a guide to clitoral sex renewed recognition of the importance of the clitoris to female sexuality. For most girls and women, the clitoris is the most important body part in terms of sexual pleasure. Parts of the clitoris The clitoris forms part of the vulva, the external ge- nitalia of a woman. The clitoris is a piece of erectile tissue, rich in nerve endings and blood vessels, and consists of various parts. Where the inner labia meet at the top, there is a foreskin, the prepuce or clitoral hood, covering the clitoral glans or head.
  • Anatomy and Physiology of the Clitoris, Vestibular Bulbs, and Labia Minora with a Review of the Female Orgasm and the Prevention of Female Sexual Dysfunction

    Anatomy and Physiology of the Clitoris, Vestibular Bulbs, and Labia Minora with a Review of the Female Orgasm and the Prevention of Female Sexual Dysfunction

    Clinical Anatomy 26:134–152 (2013) REVIEW Anatomy and Physiology of the Clitoris, Vestibular Bulbs, and Labia Minora With a Review of the Female Orgasm and the Prevention of Female Sexual Dysfunction VINCENZO PUPPO* Centro Italiano di Sessuologia (CIS), Via Regnoli 74, Bologna, Italy This review, with 21 figures and 1 video, aims to clarify some important aspects of the anatomy and physiology of the female erectile organs (triggers of orgasm), which are important for the prevention of female sexual dysfunction. The clitoris is the homologue of the male’s glans and corpora cavernosa, and erection is reached in three phases: latent, turgid, and rigid. The vestibular bulbs cause ‘‘vaginal’’ orgasmic contractions, through the rhythmic contraction of the bulbocavernosus muscles. Because of the engorgement with blood during sexual arousal, the labia minora become turgid, doubling or tripling in thickness. The corpus spongiosum of thefemaleurethrabecomescongestedduring sexual arousal; therefore, male erection equals erection of the female erectile organs. The correct anatomical term to describe the erectile tissues responsible for female orgasm is the female penis. Vaginal orgasm and the G-spot do not exist. These claims are found in numerous articles that have been written by Addiego F, Whipple B, Jannini E, Buisson O, O’Connell H, Brody S, Ostrzenski A, and others, have no scientific basis. Orgasm is an intense sensation of pleasure achieved by stimulation of erogenous zones. Women do not have a refractory period after each orgasm and can, therefore, ex- perience multiple orgasms. Clitoral sexual response and the female orgasm are not affected by aging. Sexologists should define having sex/love making when orgasm occurs for both partners with or without vaginal intercourse.
  • Vasculogenic Female Sexual Dysfunction: the Hemodynamic Basis for Vaginal Engorgement Insuf®Ciency and Clitoral Erectile Insuf®Ciency

    Vasculogenic Female Sexual Dysfunction: the Hemodynamic Basis for Vaginal Engorgement Insuf®Ciency and Clitoral Erectile Insuf®Ciency

    International Journal of Impotence Research (1997) 9, 27±37 ß 1997 Stockton Press All rights reserved 0955-9930/97 $12.00 Vasculogenic female sexual dysfunction: The hemodynamic basis for vaginal engorgement insuf®ciency and clitoral erectile insuf®ciency K Park, I Goldstein, C Andry, MB Siroky, RJ Krane and KM Azadzoi Department of Urology, Boston University School of Medicine and Boston Veteran's Administration Hospital, Boston, MA, USA Objective: Organic female sexual dysfunction may be related in part to vasculogenic impairment of the hypogastric-vaginal/clitoral arterial bed. The aim was to develop an animal model of vaginal engorgement insuf®ciency and clitoral erectile insuf®ciency. Methods: Pelvic nerve stimulated vaginal engorgement and clitoral erection were achieved in control (normal diet, n 8) and atherosclerotic (balloon injury of aorto-iliac arteries and 0.5% cholesterol diet, n 7) New Zealand White female rabbits. After 16 weeks, novel hemodynamic variables including vaginal wall and clitoral blood ¯ow, vaginal wall and clitoral intracavernosal pressure, vaginal length, vaginal luminal pressure, blood levels of cholesterol and triglycerides, aorto-iliac angiography and vaginal wall and clitoral erectile tissue histology were recorded in the two groups. Results: Concerning pelvic nerve stimulated vaginal hemodynamic changes, there was signi®cantly less increase in blood ¯ow (ml/min/100 gm tissue), wall pressure (mmHg) and length changes (mm) in atherosclerotic (9.3 Æ 3.7, 4.8 Æ 3.8, 67.3 Æ 8.3) compared to control (13.9 Æ 4.5, 5.5 Æ 2.6, 74.1 Æ 10.0) animals respectively. Histologic examination of clitoral erectile tissue demonstrated cavernosal artery atherosclerotic changes and diffuse vaginal and clitoral ®brosis.
  • Module 4: Erectile Dysfunction

    Module 4: Erectile Dysfunction

    MODULE 4: ERECTILE DYSFUNCTION KEYWORDS: Erectile dysfunction, phosphodiesterase inhibitors, sexual dysfunction LEARNING OBJECTIVES At the end of this clerkship, the medical student will be able to: 1. Draw, identify and name the major anatomic regions of the penis involved with erections 2. Describe the physiology of the normal penile erection 3. List and briefly describe the major causes of erectile dysfunction (ED) 4. List the important components of the history when interviewing a patient with ED 5. Outline the important components of the physical exam of a patient with ED 6. List the treatment options for erectile dysfunction and describe the mechanisms by which they work 7. Describe the contra-indications and side-effects of phosphodiesterase inhibition for ED 8. Describe when a patient with ED should be referred to a urologist DEFINITION Erectile dysfunction is defined as the inability to achieve and maintain an erection sufficient for satisfactory sexual intercourse. It is estimated to affect 20 to 30 million men in the US. ED may result from impairment of one or most commonly, a combination of factors: psychological, neurologic, hormonal, arterial, and venous. More recently it has become clear that, in many cases, ED may be a “silent marker” for the later development of endothelial dysfunction and eventually, cardiovascular disease. THE PENILE ERECTION Penile erection is a neurovascular event subject to psychological and hormonal modulation. Upon sexual stimulation, nerve impulses release neurotransmitters from the cavernous nerve terminals and relaxing factors from the endothelial cells in the penis. Resultant smooth muscle relaxation in the arteries and arterioles supplying the erectile tissue results in a several-fold increase in blood flow.
  • Establishment of the Autonomic Neuroanatomy to the Vulval Erectile Tissues

    Establishment of the Autonomic Neuroanatomy to the Vulval Erectile Tissues

    ESTABLISHMENT OF THE AUTONOMIC NEUROANATOMY TO THE VULVAL ERECTILE TISSUES by SHONA MARIE LOUISE PENHALE B.Sc, The University of British Columbia, 2000 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQU1RMENTS FOR THE DEGREE OF MASTERS OF SCIENCE in FACULTY OF GRADUATE STUDIES (DEPARTMENT OF ANATOMY) We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA September 2003 © Shona Marie Louise Penhale UBC Rare Books and Special Collections - Thesis Authorisation Form Page 1 of 1 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. The University of British Columbia Vancouver, Canada http://www.library.ubc.ca/spcoll/thesauth.html 07/10/2003 ABSTRACT Erectile tissues are the vascular structures within the vulva that fill with blood and are an integral component of the woman's sexual response. Despite the importance of these structures to her sexual function, the detailed neuroanatomical pathways of the autonomic nerves underlying this mechanism of vascular congestion, have not been elucidated. Therefore, this research had been designed to identify the missing components to answer the question: "What is the pathway of the nerves running from the female pelvic plexus to the external genitalia?".
  • 68 External Genitalia-Male

    68 External Genitalia-Male

    External Genitalia-Male Penis The penile urethra serves as a common channel for conducting urine and seminal fluid to the exterior. It is contained within a cylinder of erectile tissue, the corpus cavernosum urethrae (corpus spongiosum) that lies ventral to a pair of similar erectile bodies called the corpora cavernosa penis. Together the three structures make up the bulk of the penis, the copulatory organ of the male. The corpora cavernosa penis begins as separate bodies along the rami of the pubis on either side and joins at the pubic angle to form the shaft of the penis. They are united by a common connective tissue septum called the pectiniform septum, and each corpus is surrounded by a thick, primarily collagenous sheath, and the tunica albuginea. Trabeculae of collagenous and elastic fibers with numerous smooth muscle cells extend into the corpora from the tunica albuginea and divide the central regions of the corpora cavernosa into numerous cavernous spaces, those near the center being the larger. These spaces are endothelial-lined vascular spaces and are continuous with the arteries that supply them and with draining veins. The cavernous tissue of each corpus cavernosum penis communicates with the other through numerous slitlike openings in the pectiniform septum. The ventrally placed corpus cavernosum urethrae (corpus spongiosum) ends in an enlargement, the glans penis, which forms a cap over the ends of the corpora cavernosa penis. Structurally, corpus spongiosum is similar to the corpora cavernosa penis, but the tunica albuginea is thinner and contains more elastic fibers and smooth muscle cells, and the trabeculae are thinner and contain more elastic tissue.
  • The Role of Oxygen Tension in Penile Erection and Its Relationship to Erectile Dysfunction

    The Role of Oxygen Tension in Penile Erection and Its Relationship to Erectile Dysfunction

    Articles TheScientificWorldJOURNAL (2004) 4 (S1), 279–290 ISSN 1537-744X; DOI 10.1100/tsw.2004.77 The Role of Oxygen Tension in Penile Erection and Its Relationship to Erectile Dysfunction Jong-Kwan Park, M.D., Ph.D.1, Robert B. Moreland, Ph.D.2, and Ajay Nehra, M.D.1 1Department of Urology; Mayo Clinic and Foundation, and Mayo Medical School, Rochester, Minnesota 55905; 2Departments of Urology and Physiology, Boston University School of Medicine, Boston, Massachusetts 02118 E-mails: [email protected] Previously published in the Digital Urology Journal The corpus cavernosum of the penis is one of the few vascular beds in which there is a change in oxygen tension with function (blood PO2 25-40mm Hg in the flaccid state, and 90-100mm Hg in the erect state). This change in oxygen tension exposes the components of the corpus cavernosum to a variety of cytokines, humoral, vasoactive, and growth factors which may affect the structure and function of the endothelial cells, smooth muscle cells, neurons and extracellular matrix. Among these cell types, endothelial cells are the first line of defense to blood-borne stress and can affect the underlying smooth muscle via paracrine mechanisms. Impotence is defined as the inability to obtain or sustain an erection sufficient for vaginal penetration and can result from a variety of pathological conditions, vascular disease, endocrine disease, neurological disease, and psychogenic disorders. The penis is a vascular organ and as such is susceptible to the effects of vascular diseases. This review will discuss the basic etiology of erection and vasculogenic erectile dysfunction and explore the role oxygen tension in regulating various cellular and humoral factors as well as trabecular structure and function.
  • Erectile Dysfunction (ED) in Men Is Neural System, and Experiencing Ejaculation Relies on Straight

    Erectile Dysfunction (ED) in Men Is Neural System, and Experiencing Ejaculation Relies on Straight

    Dear Dr. Myrtle, clitoris (aka corpus cavernosa), and small blood When a man wants to use his penis for sexual as it has all of your life, and can make relationship What is ED? vessel function. Having an orgasm further tests the penetration, he needs this hardness to hold his penis problems difficult to solve. Erectile Dysfunction (ED) in men is neural system, and experiencing ejaculation relies on straight. Penetration can occur with softer erections, To find a professional who is particularly defined as an inability to achieve and maintain a penile yet another nerve system. The whole sexual system but the man needs to be careful not to bend the knowledgeable about sexual issues, visit the web erection sufficient for penetration. There is a broad isn’t complicated, but does require many parts to penis, since the elastic/fibrous clitoris can be broken site of the American Association of Sex Educators, range of erection troubles including: work together for sexual arousal to fully develop. when bent at an angle. Counselors and Therapists (www.aasect.org.) On • the inability to become hard at all, There are two ways to consciously initiate penile Physical Causes of Erectile Dysfunction their web page you will find public information on • becoming hard only briefly, erections: Today we know that physical causes (heart how to find a sex counselor or therapist in your area. • becoming only half-hard, and 1. Physically massage the penis, causing blood to flow disease, diabetes) of ED are more common It might be helpful to see a counselor alone, with • only occasionally becoming hard.
  • Cavernous Erectile System in Women and the Hypereroticism Area (H Area)

    Cavernous Erectile System in Women and the Hypereroticism Area (H Area)

    Journal of Clinical Sexology - Vol. 3; No.3: July- September 2020 121 CAVERNOUS ERECTILE SYSTEM IN WOMEN AND THE HYPEREROTICISM AREA (H AREA) 1*Vasile NIȚESCU 1.*Medical Centre for Obstetrics-Gynaecology and Sexology The erectile organs of the vulva, through their structure and functionality, participate directly in determining the state of arousal and erection, necessary for sexual interc urse. The command to trigger an erection is given by the brain and is transmitted through the medullary pathways and/or the sacral spinal cord S2-S4, through the reflex arch. The direct connection between the cavernous erectile organs containing a venous ple- xus (vestibular bulbs) with the erectile tissue of the clitoris, the suburethral tissue, respec- tively the cavernous venous plexus of the urethra which constitutes the Vaginal Area of Hypereroticism (”H”), stimulates the receptors of any of the above structures in order to increase the local congestion and the vulvo-vaginal erectile sensitivity, thus activating the desire to mate (the ”libido”). It has to be mentioned that the erectile tissue covered by albuginea has a special func- tionality compared to the tissue with a simple local hyperemia (Niţescu). Parasympathetic impulses dilate the arteries of erectile tissue due to acetylcholine, to nitric oxide and to VIP (Vasoactive Intestinal Polypeptide) released at the nerve endings, local hyperemia highlighting the vulvo-vaginal erectile tissue. The connections between the corpora cavernosa of the clitoris and the corpora caver- nosa of the urethra are also explained by the drainage of venous blood, that is mainly and directly to the circumflex veins, which is another proof of the direct link between the clitoris and H area, all considered by women as being the most important vulvo-vaginal erogenous zones.
  • Development of the Human Penis and Clitoris

    Development of the Human Penis and Clitoris

    Differentiation xxx (xxxx) xxx–xxx Contents lists available at ScienceDirect Differentiation journal homepage: www.elsevier.com/locate/diff ☆ Development of the human penis and clitoris ⁎ ⁎⁎ Laurence Baskin , Joel Shen, Adriane Sinclair , Mei Cao, Xin Liu1, Ge Liu1, Dylan Isaacson, Maya Overland, Yi Li, Gerald R. Cunha UCSF, USA ARTICLE INFO ABSTRACT Keywords: The human penis and clitoris develop from the ambisexual genital tubercle. To compare and contrast the de- Development velopment of human penis and clitoris, we used macroscopic photography, optical projection tomography, light Human sheet microscopy, scanning electron microscopy, histology and immunohistochemistry. The human genital tu- Penis bercle differentiates into a penis under the influence of androgens forming a tubular urethra that develops by Clitoris canalization of the urethral plate to form a wide diamond-shaped urethral groove (opening zipper) whose edges Canalization and fusion (urethral folds) fuse in the midline (closing zipper). In contrast, in females, without the influence of androgens, the vestibular plate (homologue of the urethral plate) undergoes canalization to form a wide vestibular groove whose edges (vestibular folds) remain unfused, ultimately forming the labia minora defining the vaginal ves- tibule. The neurovascular anatomy is similar in both the developing human penis and clitoris and is the key to successful surgical reconstructions. 1. Introduction literature, in recent years we have recognized that the mouse is not the ideal model for normal human penile development and hypospadias for Male and female external genitalia play an essential role in human a host of reasons (Cunha et al., 2015; Liu et al., 2018b; Sinclair et al., reproduction, and disorders of structure and function of male and fe- 2016).