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

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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.

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References

  1. Gräfenberg E. The role of urethra in female orgasm. Int J Sexol. 1950;3:145–8.

    Google Scholar 

  2. 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.

    Article  CAS  Google Scholar 

  3. Song YB, Hwang K, Kim DJ, et al. Innervation of vagina: microdissection and immunohistochemical study. J Sex Marital Ther. 2009;35:144–53.

    Article  Google Scholar 

  4. 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.

    Article  Google Scholar 

  5. 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.

    Article  Google Scholar 

  6. Ulfelder H, Robboy SJ. The embryologic development of the human vagina. Am J Obstet Gynecol 1. 1976;126(7):769–76.

    Article  CAS  Google Scholar 

  7. 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.

    CAS  PubMed  Google Scholar 

  8. 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.

    CAS  Google Scholar 

  9. 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.

    Article  Google Scholar 

  10. 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.

    Article  Google Scholar 

  11. 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.

    Article  Google Scholar 

  12. 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.

    Article  Google Scholar 

  13. 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.

    Article  Google Scholar 

  14. Ostrzenski A. G-spot anatomy: a new discovery. J Sex Med. 2012;9:1355–9.

    Article  Google Scholar 

  15. 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.

    Article  CAS  Google Scholar 

  16. 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.

    Article  Google Scholar 

  17. 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.

    CAS  Google Scholar 

  18. 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  Google Scholar 

  19. Addiego F, Belzer EG, Comolli J, et al. Female ejaculation: a case study. J Sex Res. 1981;17:13–21.

    Article  Google Scholar 

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Acknowledgements

We would like to thank Bezmialem Vakif University and the participants for their support of this study.

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Authors and Affiliations

Authors

Contributions

A. Serdar: Project Development, Manuscript writing, Data collection, Data analysis, Investigation.

F Cavide: Project Development, Data analysis, Investigation, Manuscript writing.

GK Ayse Filiz: Manuscript writing, Data collection,

G. Burcu: Data analysis, Investigation.

A. Çağrı: Manuscript writing, Data collection, Data analysis.

Corresponding author

Correspondence to Serdar Aydın.

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The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this paper.

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Aydın, S., Sönmez, F.C., Karasu, A.F.G. et al. Search for the G spot: microvessel and nerve mapping of the paraurethral anterior vaginal wall. Int Urogynecol J 31, 2565–2572 (2020). https://doi.org/10.1007/s00192-020-04379-1

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  • DOI: https://doi.org/10.1007/s00192-020-04379-1

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