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Abstract

The G-spot is an allegedly highly erogenous area on the anterior wall of the human vagina. Since the concept first appeared in a popular book on human sexuality in 1982, the existence of the spot has become widely accepted, especially by the general public. This article reviews the behavioral, biochemical, and anatomic evidence for the reality of the G-spot, which includes claims about the nature of female ejaculation. The evidence is far too weak to support the reality of the G-spot. Specifically, anecdotal observations and case studies made on the basis of a tiny number of subjects are not supported by subsequent anatomic and biochemical studies.
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Thank you,
Terence Hines, Ph.D.
Professor of Psychology
Pace University
Pleasantville, NY
USA
... It has been suggested that stimulation of this area can result in arousal, orgasm, and female ejaculation. Much of the evidence to support these claims is anecdotal if not questionable [82]. Although histologic studies have yielded conflicting results, recent work suggests that neurovascular structures along the anterior vaginal wall have a uniform distribution as opposed to concentration in one small area [83]. ...
Article
Introduction and hypothesis: The current terminology used to describe cosmetic gynecologic procedures includes many nondescriptive, trademarked, or informal names, which contributes to substantial ambiguity about their aims and specific techniques. The development of clear, uniform descriptive terminology for cosmetic gynecology is needed for patients, researchers, and practitioners across multiple specialties. Methods: This document was developed from a collaboration of selected members from the International Urogynecological Association (IUGA) and the American Urogynecologic Society (AUGS). Wide-ranging literature reviews were performed to identify the breadth of currently used terms and tools for measuring efficacy and safety. After extensive internal review the adoption of each definition was ratified by group consensus. Results: A terminology report for elective cosmetic gynecology procedures, anatomical classification, outcome metrics, and reporting of complications has been developed. This document seeks to provide clear descriptive guidance for patients, researchers, and practitioners across multiple specialties. This document will be subject to internal review by IUGA and AUGS to incorporate and adopt evidence-based changes in the field. Conclusions: A consensus-based document establishing clear terminology for cosmetic gynecology procedures has been created. Use of these terms should be encouraged to provide clarity to patients seeking these procedures and to facilitate future research to establish the safety and efficacy of these procedures.
... Interestingly, the very large majority of papers in favor of the discovery have been experimental findings, i.e., evidence, while the very large majority of articles against the existence of the G-spot have been narrative review articles, i.e., opinions, written by authors without demonstrating scientific experience in producing experimental data in the field. In a famous, but very poorly researched, review article in the American Journal of Obstetrics and Gynecology, 20 years later, the psychologist Terence Hines of Pace University, Pleasantville, NY, compared it to a sort of gynecologic UFO: "much sought for, much discussed, but unverified by objective means" [31]. In reply to this, the following year, the same authors who coined the name G-spot replied with a letter to the editor defending its existence [32,33]. ...
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In the field of female sexuality, the existence of the so-called “G-spot” represents a topic still anchored to anecdotes and opinions and explained using non-scientific points, as well as being overused for commercial and mediatic purposes. Purpose of Review The scope of this review is to give an update on the current state of information regarding the G-spot and suggesting potential future directions in the research field of this interesting, albeit controversial, aspect of human sexual physiology. Recent Findings From evolutionary, anatomical, and functional points of view, new evidence has rebutted the original conceptualization of the G-spot, abandoning the idea of a specific anatomical point able to produce exceptional orgasmic experiences through the stimulation of the anterior vaginal wall, the site where the G-spot is assumed to be. From a psychological perspective, only few findings to date are able to describe the psychological, behavioral, and social correlates of the pleasure experience by G-spot-induced or, better, vaginally induced orgasm (VAO). Summary Recent literature suggests the existence of a G-spot but specifies that, since it is not a spot, neither anatomically nor functionally, it cannot be called G, nor spot, anymore. It is indeed a functional, dynamic, and hormone-dependent area (called clitorourethrovaginal, CUV, complex), extremely individual in its development and action due to the combined influence of biological and psychological aspects, which may trigger VAO and in some particular cases also female ejaculation (FE).
... In addition, the MUS procedure involves a vertical midline vaginal incision through the anterior vaginal wall at the middle third of the urethra [7]. Therefore, the MUS procedure may affect the 'G' spot, a supersensitive and densely innervated area for sexual stimulation located in the anterior vaginal wall in some women [8,9]. Other studies also reported a reduction in blood flow and sensation in the clitoris after the MUS procedure [10,11]. ...
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Aim This prospective study aimed to evaluate sexual function in women who underwent transobturator tape (TOT) sling surgery and their male sexual partners compared to before the procedure. Materials and methods The study included a total of 202 women with stress urinary incontinence who underwent the TOT procedure between April 2018 and February 2020, and their partners. All of the women completed the Incontinence Impact Questionnaire (IIQ-7), Urogenital Distress Inventory (UDI-6), and Female Sexual Function Index (FSFI) questionnaire while their partners completed the International Index of Erectile Function (IIEF-5) questionnaire before and 6 months after the procedure. Results Mean IIQ-7 and UDI-6 scores were significantly lower at postoperative month 6 compared to preoperative values (p < 0.001). Mean FSFI scores were 22.5 ± 1.7 preoperatively and 27.8 ± 1.6 at postoperative month 6 (p < 0.001). Pain score did not change significantly (p = 0.4), but there were significant increases in the other FSFI domains of desire, arousal, lubrication, and satisfaction (p < 0.001, p < 0.001, p < 0.001, p < 0.001). The partners’ mean IIEF score was 50.05 ± 5.4 preoperatively and increased to 59.7 ± 6.8 postoperatively (p < 0.001). No significant differences were detected in erectile or orgasmic function (p = 0.16, p = 0.67), whereas desire, intercourse satisfaction, and overall satisfaction scores increased significantly (p < 0.001, p < 0.001, p < 0.001). Conclusion TOT surgery improves sexual function not only in women but also their partners.
... Its location and structure arelike that of the man prostate gland (Zaviačič, 1985(Zaviačič, , 1999. Some researchers relate the function of this gland to the so-called G-spot and the ejaculation of women, although at present and, despite all historical, anthropological, anatomical, functional and biochemical contributions (Grafenberg, 1950;Sevely and Bennett, 1978;Addiego et al., 1981;Belzer, 1984;Zaviačič and Whipple, 1993;Hines, 2001;Levin, 2003), the phenomenon of the so-called female ejaculation still generates many discussions and controversies (Puppo, 2011). ...
Article
Some years ago, our group reported the presence of the female prostate in all the studied females of the plains viscacha (Lagostomus maximus). The goal of the present study was to characterize and compare the female prostate gland between adult pregnant and non-pregnant plains viscacha using histochemical, lectin-histochemical and immunohistochemical techniques, as well as optic and electron microscopy. Structurally, alveoli are lined by a simple epithelium formed by different cell types: basal cells, secretory cells in different stages of the secretory cycle and cells of clear cytoplasm. Secretory cells are the most abundant cell type, differing between them depending on the quantity and electron-density of their granules. The basal cells are less abundant and are responsible for the renewal of the alveolar epithelium. Likewise, other cells with secretory morphology were found in all the studied females; these have a clear cytoplasm, few granules and mitochondria. It could be considered that they are degranulated secretory cells or that they have partially released their granules. The stroma of the organ is formed by connective tissue and smooth muscle fibers, which are immunohistochemically evidenced against desmin. Histochemical and lectin-histochemical analysis revealed the presence of different glucidic residues in the different cell types. No structural, histochemical, lectin-histochemical, and ultrastructural differences were observed between pregnant and non-pregnant females of plain viscachas, except for the expression of some lectins. The paraurethral gland of Lagostomus maximus can be used as a model for studying the gland in other species since its structural and ultrastructural characteristics do not depend on the hormonal status of the female.
... A vertical midline vaginal incision is performed in the middle third of the urethra passing through the thickness of the anterior vaginal wall in the MUS procedure [2]; thus, the MUS procedure may affect the 'G' spot. The 'G' spot is a supersensitive and densely innervated area for sexual excitement in some women and is located in the anterior vaginal wall [3,4]. A decrease in clitoral blood flow and sensation in the clitoral and anterior vaginal wall region has been noted after the MUS procedure [5,6]. ...
Article
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Objective To assess the impact of the transobturator mid-urethral sling (MUS) procedure on female sexual function and their partners’ sexual activity. Materials and methods Sexually active women with stress urinary incontinence who underwent a transobturator MUS procedure at the Department of Obstetrics and Gynecology of two medical centers were prospectively enrolled. All participants and their partners were required to complete questionnaires before surgery and 3 months after surgery. Results Eighteen women undergoing both the transobturator tape (TOT) procedure (n = 14) and the tension-free vaginal tape obturator (TVT-O) procedure (n = 4) were enrolled. The female sexual function index scores did not differ between the baseline and postoperative data. However, the overactive bladder symptom scores improved significantly 3 months after surgery. Patients also had an improvement in their arousal score after TOT procedures; however, there was no between-group difference in the post-treatment changes in the arousal scores. Thirteen partners completed their questionnaires at both the baseline and postoperative phases. Fifty-four percent (7/13) of partners stated that sexual intercourse improved after surgery, and 46% (6/13) described no change after surgery. In addition, no change in pain level due to vaginal narrowing or dryness after surgery was observed. Only one partner noticed the tape during intercourse and complained of pain due to the tape. Conclusion Although most female sexual function remains unchanged after the transobturator MUS procedure, a significant percentage of partners in the study felt that their sexual activity improved after surgery.
Article
Introduction: There is evidence of glandular tissue within the region of the anterior vaginal wall-female periurethral tissue (AVW-FPT) having similar morphology and immunohistochemistry to the prostate in men and having physiological roles in the female sexual response (FSR). Whether this tissue should be called a prostate in women has been debated. Iatrogenic injury to structures of the AVW-FPT, including these glands and the associated neurovasculature, could be a cause of female sexual dysfunction (FSD). Objectives: To consolidate the current knowledge concerning the glandular tissue surrounding the urethra in women, evidence was reviewed to address whether: (i) these glands comprise the prostate in women, (ii) they have specific functions in the FSR, and (iii) injury to the AVW-FPT and prostate has sexual dysfunction as a likely outcome. Methods: A literature review was conducted using keywords including female prostate, Skene’s/paraurethral glands, periurethral tissue, Gr€afenberg (G)-spot, female ejaculation, mid-urethral sling (MUS), and sexual dysfunction. Results: Histological and immunohistochemical studies of the glandular tissue surrounding the urethra support the existence of prostate in women. Evidence suggests this tissue may have physiologically and clinically relevant autonomic and sensory innervation, and during sexual arousal may contribute to secretions involved in ejaculation and orgasm. Gaps in knowledge relating to the functional anatomy, physiological roles, and embryological origins of this tissue have impeded the acceptance of a prostate in women. Injury to the innervation, vasculature, and/or glandular tissue within the surgical field of MUS implantation suggests iatrogenic sexual dysfunction is plausible. Conclusions: Continuing to advance our understanding of the morphology, histochemistry, and physiologic capacity of this glandular tissue will clarify the characterization of this tissue as the “prostate” involved in the FSR, and its role in FSD following surgical injury.
Article
With advances in the standards of living and public perceptions, female genital cosmetic surgery is becoming a new hot topic in the field of plastic surgery, gaining considerable interest recently among beauty seekers and professionals alike. However, the needs of beauty pursuers seem to be exuberant but vague; on the other hand, practitioners who have received strict professional training are still desperately needed. Additionally, interest-driven marketing and promotion render the field prone to chaos, resulting in widespread attention and concerns regarding the scientificity, safety, effectiveness, and necessity of the performance of multiple treatment procedures. Extensive survey of the relevant literature was performed, and several beauty seekers as well as surgeons with working experience of pertinent techniques were consulted, in order to examine the current status and future developments of this field.
Chapter
Human sexual response is covered in this chapter, including the male and female genitalia, the biological and psychological influences on our sexual response, theories of sexual response, sexual arousal, and sexual desire.
Article
Research has shown that infertile women are less satisfied with their lives than fertile women, as their mental, communicative, sexual and emotional well-being is undergoing a number of changes, especially in the late reproductive period when the proportion increases anxiety and depressive disorders. The objective: сompare the quality of life parameters in infertile and fertile women of late reproductive age with endometrial pathology. Patients and methods. The study included 237 women 35–44 years with different clinical forms of endometrial pathology. A questionnaire health SF-36 is used for studying the quality of life. Results. The study of quality of life showed that patients with infertility compared with fertile women significantly higher assessed and psychological (p<0.008) and the physical component of their health (p<0.02), showed the greatest difference in emotional functioning (p<0.002). It was revealed that the longer the sterility, the worse the patients rated their physical functioning (с=-0.32, p<0.001) and mental health (с=-0.25, p<0.02), and the higher their overall health satisfaction (с=0.28, p<0.004).A subjective satisfaction with the physical and mental state is assessed. It was found that the age lowers the quality of life assessment more than a period of infertility. According to data obtained in the study of quality of life does not depend from infertility factors, but is largely determined by the presence of children. Conclusions. It is concluded that the quality of life of secondary infertile women closest to the profile of fertile women; patient late reproductive age with infertility and endometrial pathology more satisfied with their lives than fertile women with endometrial pathology similar age. Key words: endometrial pathology, late reproductive period, infertility, quality of life.
Article
A case study of large‐volume vaginal discharge during intercourse originally prepared in 1979, is described, as is the course of investigation into its origin. It is argued that this “wetting of the bed” is not a pathological significance but is within the normal range and variation of the physiological function of the paraurethral glands of Skene. A 1982 addendum discusses developments in this field of sexual research, including the rediscovery of female ejaculation; 2 decades dominated by the “paradigm of cliterocentricity” and a recent shift back to the vagina, specifically the urethro‐vaginal body, in female sexual function. A 1983 addendum reports on an immunohistochemical demonstration of the homology between the female urethral glands and the male prostate. Evidence for the secretion of prostatic acid phosphatase by the female glands suggests an ejaculatory function equivalent to that of the male though without the gonadal, “seminal” component. Further investigations of female ejaculation are discussed.
Article
This paper is based on a study of the centuries‐long controversy over female ejaculation. Culture and language tend to obscure knowledge that the human female has a prostate gland and is capable of ejaculation. Despite this existing scientific knowledge, contemporary research on female sexuality presupposes that women do not ejaculate. Nevertheless, current findings establish that more similarities than differences exist between men and women in coital responses. To the known homologues in adult urogenital anatomy are added female and male prostates. Studies of the female prostate (urethral glands) report marked variation from woman to woman in the extent and size of these glandular structures. The more recent clinical literature is oriented towards anatomy and pathology, whereas de Graaf's seventeenth‐century treatise documents not only the anatomy of the female prostate, but also the discharge of prostatic fluid from the female urethra described as a cause of pleasure. How denial of this phenomenon came about is traced to semantic confusion over the word “semen” in relation to the Aristotelian controversy concerning the procreative function of female fluids. This study concludes that women can ejaculate, and that the female prostatic fluid discharged through the urethra is a component of female sexual fluids that contribute to erotic pleasure.
Article
A literature review supplemented interviews with informants who were confident they had personal experience with female orgasmic expulsion. It was concluded that female ejaculation of secretion from the embryologic homologue to the male prostate is theoretically plausible. Research efforts to affirm or discredit its existence on an objective basis were seen to be warranted. The assumption that female orgasmic expulsions must be due to urinary incontinence was challenged. Anecdotal evidence prompted the hypothesis that orgasm accompanied by ejaculation tends to be followed by a refractory period in women, as in men.
Article
This case study provides objective evidence supporting the hypothesis that female ejaculation, a partial, infertile homologue of male ejaculation, exists. A karyotypically normal, multiparous woman suffered for a decade with urinary stress incontinence. During that time she had learned to inhibit an orgastic response which led to bedwetting. Although the liquid produced did not appear to be urine, she falsely concluded that her orgasmic expulsion was a manifestation of urinary incontinence. Using feedback from a Vaginal Myograph, she learned to do Kegel exercises properly, and the urinary stress incontinence soon disappeared. Around this time she became aware of the concept of female ejaculation and its possible association with an erotically sensitive area that could be stimulated through her anterior vaginal wall. Stimulation of this area, the “Grafenberg spot,” produced what she described as orgasm which felt “deeper” than orgasms in response to vulvar stimulation. Such an orgasm was often accompanied by expulsion of liquid from the urethra. Chemical analysis indicated that the expulsion was not urine. It contained prostatic acid phosphatase, an enzyme characteristically found in prostatic secretion.
Recent advances in forensic science in the identification of human seminal acid phosphatase are presented, with particular attention to the acrylamide gel electrophoretic method. In that method a difficulty in distinguishing seminal acid phosphatase from certain fecal phosphatases has been observed and an attempt is made here to distinguish the phosphatases from one another experimentally by differential substrate specificity. 4-Methylumbelliferyl phosphate and alpha-naphthyl acid phosphate are used as reaction substrates. Although seminal and vaginal acid phosphatases are differentiated by the modified method, fecal phosphatase is not clearly differentiated from seminal acid phosphatase.