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Erschienen in: International Urogynecology Journal 12/2020

23.06.2020 | Original Article

Search for the G spot: microvessel and nerve mapping of the paraurethral anterior vaginal wall

verfasst von: Serdar Aydın, Fatma Cavide Sönmez, Ayşe Filiz Gökmen Karasu, Burcu Gül, Çağrı Arıoğlu

Erschienen in: International Urogynecology Journal | Ausgabe 12/2020

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Abstract

Introduction and hypothesis

Orgasm and other sexual responses such as pain, arousal and lubrication may be mediated by nerve fibers and vessels in the lamina propria and muscularis of the vaginal wall, in which case the number of nerve fibers and vessels would be associated with sexual functions. The aim of the study is to map the distribution of nerves and vessels in the anterior vaginal wall along the paraurethral region in a systematic fashion.

Methods

Specimens were taken from women with anterior vaginal wall prolapse undergoing colporrhaphy anterior repair. All specimens were mapped in a standard way starting 15 mm proximal to the external urethral orifice. Selected blocks of samples were immunohistochemically stained: actin, smooth muscle Ab-1 and S100 Protein Ab-1. The numbers of microvessels and nerves in the lamina propria and muscularis were counted in five consecutive high-power fields of a light microscope. Pairwise comparisons of proximal, distal, right and left paravaginal microvessel and nerve fiber density were analyzed with paired-sample t-test or Wilcoxon signed-rank test.

Results

Vaginal nerve fibers in the lamina propria and muscularis have a fairly even distribution in the anterior vaginal wall. Vaginal small vessel vascularization and microvascularization are also evenly distributed, with no concentrated site along the paraurethral region of the anterior vaginal wall.

Conclusions

Nerve fiber, nerve bundle, microvessel and small vessel densities in the lamina propria and muscularis were fairly regular, with no concentrated site on the paraurethral region of the anterior vaginal wall.
Literatur
1.
Zurück zum Zitat Gräfenberg E. The role of urethra in female orgasm. Int J Sexol. 1950;3:145–8. Gräfenberg E. The role of urethra in female orgasm. Int J Sexol. 1950;3:145–8.
2.
Zurück zum Zitat Hilliges M, Falconer C, Ekman-Ordeberg G, Johansson O. Innervation of the human vaginal mucosa as revealed by PGP 9.5 immunohistochemistry. Acta Anat (Basel). 1995;153:119–26.CrossRef Hilliges M, Falconer C, Ekman-Ordeberg G, Johansson O. Innervation of the human vaginal mucosa as revealed by PGP 9.5 immunohistochemistry. Acta Anat (Basel). 1995;153:119–26.CrossRef
3.
Zurück zum Zitat Song YB, Hwang K, Kim DJ, et al. Innervation of vagina: microdissection and immunohistochemical study. J Sex Marital Ther. 2009;35:144–53.CrossRef Song YB, Hwang K, Kim DJ, et al. Innervation of vagina: microdissection and immunohistochemical study. J Sex Marital Ther. 2009;35:144–53.CrossRef
4.
Zurück zum Zitat Li T, Liao Q, Zhang H, et al. Anatomic distribution of nerves and microvascular density in the human anterior Vaginal Wall: prospective study. PLoS One. 2014;9(11):e110239.CrossRef Li T, Liao Q, Zhang H, et al. Anatomic distribution of nerves and microvascular density in the human anterior Vaginal Wall: prospective study. PLoS One. 2014;9(11):e110239.CrossRef
5.
Zurück zum Zitat Pauls R, Mutema G, Segal J, et al. A prospective study examining the anatomic distribution of nerve density in the human vagina. J Sex Med. 2006;3:979–87.CrossRef Pauls R, Mutema G, Segal J, et al. A prospective study examining the anatomic distribution of nerve density in the human vagina. J Sex Med. 2006;3:979–87.CrossRef
6.
Zurück zum Zitat Ulfelder H, Robboy SJ. The embryologic development of the human vagina. Am J Obstet Gynecol 1. 1976;126(7):769–76.CrossRef Ulfelder H, Robboy SJ. The embryologic development of the human vagina. Am J Obstet Gynecol 1. 1976;126(7):769–76.CrossRef
7.
Zurück zum Zitat Johansson O, Wang L, Hilliges M, et al. Intraepidermal nerves in human skin: PGP 9.5 immunohistochemistry with special reference to the nerve density in skin from different body regions. J Peripher Nerv Syst. 1999;4:43–52.PubMed Johansson O, Wang L, Hilliges M, et al. Intraepidermal nerves in human skin: PGP 9.5 immunohistochemistry with special reference to the nerve density in skin from different body regions. J Peripher Nerv Syst. 1999;4:43–52.PubMed
8.
Zurück zum Zitat Jiang M, Li K, Li S, et al. Calretinin, S100 and protein gene product 9.5 immunostaining of rectal suction biopsies in the diagnosis of Hirschsprung' disease. Am J Transl Res 15. 2016;8(7):3159–68. Jiang M, Li K, Li S, et al. Calretinin, S100 and protein gene product 9.5 immunostaining of rectal suction biopsies in the diagnosis of Hirschsprung' disease. Am J Transl Res 15. 2016;8(7):3159–68.
9.
Zurück zum Zitat Feldner PC Jr, Delroy CA, Martins SB, et al. Sexual function after anterior vaginal wall prolapse surgery. Clinics (Sao Paulo). 2012. 2016;67(8):871–5.CrossRef Feldner PC Jr, Delroy CA, Martins SB, et al. Sexual function after anterior vaginal wall prolapse surgery. Clinics (Sao Paulo). 2012. 2016;67(8):871–5.CrossRef
10.
Zurück zum Zitat Morselli S, Li Marzi V, Verrienti P, et al. Transvaginal mesh surgery for pelvic organ prolapse does not affect sexual function at long term follow up. Eur J Obstet Gynecol Reprod Biol. 2019;240:282–7.CrossRef Morselli S, Li Marzi V, Verrienti P, et al. Transvaginal mesh surgery for pelvic organ prolapse does not affect sexual function at long term follow up. Eur J Obstet Gynecol Reprod Biol. 2019;240:282–7.CrossRef
11.
Zurück zum Zitat Sentilhes L, Berthier A, Sergent F, et al. Sexual function in women before and after transvaginal mesh repair for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(6):763–72.CrossRef Sentilhes L, Berthier A, Sergent F, et al. Sexual function in women before and after transvaginal mesh repair for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(6):763–72.CrossRef
12.
Zurück zum Zitat Farthmann J, Mengel M, Henne B, et al. Improvement of pelvic floor-related quality of life and sexual function after vaginal mesh implantation for cystocele: primary endpoint of a prospective multicentre trial. Arch Gynecol Obstet. 2016;294(1):115–21.CrossRef Farthmann J, Mengel M, Henne B, et al. Improvement of pelvic floor-related quality of life and sexual function after vaginal mesh implantation for cystocele: primary endpoint of a prospective multicentre trial. Arch Gynecol Obstet. 2016;294(1):115–21.CrossRef
13.
Zurück zum Zitat Szell N, Komisaruk B, Goldstein SW, et al. A meta-analysis detailing overall sexual function and orgasmic function in women undergoing midurethral sling surgery for stress incontinence. Sex Med. 2017;5:e84–93.CrossRef Szell N, Komisaruk B, Goldstein SW, et al. A meta-analysis detailing overall sexual function and orgasmic function in women undergoing midurethral sling surgery for stress incontinence. Sex Med. 2017;5:e84–93.CrossRef
14.
Zurück zum Zitat Ostrzenski A. G-spot anatomy: a new discovery. J Sex Med. 2012;9:1355–9.CrossRef Ostrzenski A. G-spot anatomy: a new discovery. J Sex Med. 2012;9:1355–9.CrossRef
15.
Zurück zum Zitat Ostrzenski A, Krajewski P, Ganjei-Azar P, et al. Verification of the anatomy and newly discovered histology of the G-spot complex. BJOG. 2014;121:1333–9.CrossRef Ostrzenski A, Krajewski P, Ganjei-Azar P, et al. Verification of the anatomy and newly discovered histology of the G-spot complex. BJOG. 2014;121:1333–9.CrossRef
16.
Zurück zum Zitat Hoag N, Keast JR, O’Connell HE. The “G-spot” is not a structure evident on macroscopic anatomic dissection of the Vaginal Wall. J Sex Med. 2017;14:1524e1532.CrossRef Hoag N, Keast JR, O’Connell HE. The “G-spot” is not a structure evident on macroscopic anatomic dissection of the Vaginal Wall. J Sex Med. 2017;14:1524e1532.CrossRef
17.
Zurück zum Zitat Zhu L, Lang J, Chen J, et al. Study on nerve fiber in anterior vaginal epithelium for stress urinary incontinence. Int Urogynecol J. 2004;15:272–5. Zhu L, Lang J, Chen J, et al. Study on nerve fiber in anterior vaginal epithelium for stress urinary incontinence. Int Urogynecol J. 2004;15:272–5.
18.
Zurück zum Zitat Inal HA, Kaplan PB, Usta U, et al. Neuromuscular morphometry of the vaginal wall in women with anterior vaginal wall prolapse. Neurourol Urodyn. 2010;29(3):458–63.PubMed Inal HA, Kaplan PB, Usta U, et al. Neuromuscular morphometry of the vaginal wall in women with anterior vaginal wall prolapse. Neurourol Urodyn. 2010;29(3):458–63.PubMed
19.
Zurück zum Zitat Addiego F, Belzer EG, Comolli J, et al. Female ejaculation: a case study. J Sex Res. 1981;17:13–21.CrossRef Addiego F, Belzer EG, Comolli J, et al. Female ejaculation: a case study. J Sex Res. 1981;17:13–21.CrossRef
Metadaten
Titel
Search for the G spot: microvessel and nerve mapping of the paraurethral anterior vaginal wall
verfasst von
Serdar Aydın
Fatma Cavide Sönmez
Ayşe Filiz Gökmen Karasu
Burcu Gül
Çağrı Arıoğlu
Publikationsdatum
23.06.2020
Verlag
Springer International Publishing
Erschienen in
International Urogynecology Journal / Ausgabe 12/2020
Print ISSN: 0937-3462
Elektronische ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-020-04379-1

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