Clitoral anatomy in nulliparous, healthy, premenopausal volunteers using unenhanced magnetic resonance imaging.

Department of Surgery, University of Melbourne, Parkville, Victoria, Australia.
The Journal of Urology (Impact Factor: 4.47). 07/2005; 173(6):2060-3. DOI: 10.1097/01.ju.0000158446.21396.c0
Source: PubMed


We determined the magnetic resonance imaging (MRI) characteristics of normal clitoral anatomy.
A series of MRI studies of 10 healthy, nulliparous volunteers with no prior surgery and normal pelvic examination was studied and the key characteristics of clitoral anatomy were determined. A range of different magnetic resonance sequences was used without any contrast agent.
The axial plane best revealed the clitoral body and its proximal continuation as the paired crura. The glans was seen more caudal than the body of the clitoris. The bulbs of the clitoris had the same signal as the rest of the clitoris in the axial plane and they related consistently to the other erectile structures. The bulbs, body and crura formed an erectile tissue cluster, namely the clitoris. In turn, the clitoris partially surrounded the urethra and vagina, forming a consistently observed tissue complex. Midline sagittal section revealed the shape of the body, although in this plane the rest of the clitoris was poorly displayed. The coronal plane revealed the relationship between the clitoral body and labia. The axial section cephalad to the clitoral body best revealed the vascular component of the neurovascular bundle to the clitoris. The fat saturation sequence particularly highlighted clitoral anatomy in healthy, premenopausal, nulliparous women.
Normal clitoral anatomy has been clearly demonstrated using noncontrast pelvic MRI.

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Available from: Helen E O'Connell
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    • "Cependant, cette hypothèse n'est pas corroborée par deux études [14] [15]. Le clitoris a été aussi étudié à l'aide de clichés d'IRM du périnée féminin [14] [17] qui offrait une autre approche radio-anatomique selon les auteurs, notamment par rapport au fait qu'ils respectaient la position in situ du clitoris et que la population étudiée était jeune et non ménopausée. Aucune étude sur la dynamique du clitoris en érection n'a été analysée, ce qui aurait pu apporter des informations complémentaires. "
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    ABSTRACT: Objectives To describe the course of the dorsal nerve of the clitoris (DNC) to better define its anatomy in the human adult and to help surgeons to avoid iatrogenic injury during surgical procedures. Method An extensive review of the current literature was done on Medline via PubMed by using the following keywords: “anatomie du clitoris”, “anatomy of clitoris”, “nerf dorsal du clitoris”, “dorsal nerve of clitoris”, “réparation clitoridienne”, “transposition clitoridienne”, “surgery of the clitoris”, “clitoridoplasty”. This review analyzed dissection, magnetic resonance imaging, 3-dimensional sectional anatomy reconstruction and immuno-histochemical studies. Results The DNC comes from the pudendal nerve. He travels from under the inferior pubis ramus to the posterosuperior edge of the clitoral crus. The DNC reappears under the pubic symphysis and enters the deep component of the suspensory ligament. He runs on the dorsal face of the clitoral body at 11 and 1 o’clock. Distally, he gives many nervous ramifications, runs along the tunica and enters the glans. Conclusion The NDC might be surgically injured (i) under the pubic symphysis, at the union of the two crus of clitoris and (ii) on the dorsal surface of the clitoral body. The pathway of the DNC on the dorsal face of the clitoris permits to approach the ventral face of the clitoris without risk of iatrogenic injuries. The distance between the pubic symphysis and the DNC implies that the incision should be done just under the pubic symphysis. Distally, the dissection of the DNC next the glands appears as dangerous and impossible, considering that the DNC is too close to the glandular tissues.
    Full-text · Article · Jan 2014
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    • "Androgens may also have effects on female sexual functions, although further studies are needed to understand it comprehensively [Yamada et al. 2006; Johnson and Berman, 2005]. O'Connell and Delancey have recently studied the androgenic and estrogenic activities of the corpus cavernosum cells [O'Connell and Delancey, 2005]. However, there is still a lack of information on the responses of the tissue and the regulatory mechanisms of the organ. "
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    ABSTRACT: A review of the literature regarding the current state of knowledge of the anatomic and physiologic features of the female clitoris was conducted. Based on this evaluation, operations on the clitoris were reviewed. The anatomic and physiologic reconstruction problems of surgical techniques for female pseudohermaphroditism that have previously been reported were reviewed. The author suggests that clitoroplasty is essential for patients with ambiguous genitalia, but the decision regarding the correct procedure, taking into account anatomic and physiologic success, can be controversial. This may be because of unclear anatomic and physiologic definitions, even for healthy people. As a temporary solution, more conservative procedures for maximally effective treatment are suggested.
    Preview · Article · Dec 2011 · Therapeutic Advances in Urology
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