Abstract
In the past a few attention was paid in literatures and social informations towards the normal and abnormal female clitoris and prepuce, only during the second half of the twentieth century, the stream of data and debates about external female organs start to emerge, but sometimes these informations are inaccurate or not conclusive, at the main time the absence of accepted terms of the intimate parts of the female genitalia can influence the meaning of descriptions. A detailed understanding of the normal anatomy of the female external genital tract in general, clitoris and prepuce in particular is necessary to reconstruct patients with intersex and other genital anomalies and to achieve a favorable outcomes. Also in male-to-female genital sex reassignment surgery, the clitoris, its prepuce, and the labia minora remain among the most difficult structures to construct. However until recently the normal pediatric female genital anatomy was not well described, even there is no universal agreement about the terminology of some parts of these organs, also in many researches and illustrations there is some confusion between clitorial and preputial anatomy, anomalies and functions. The female prepuce, which is homologue to the male prepuce has a special and intricate anatomy, it projects at the front of the labial commissure, where the edges of the labia meet at the base of the clitoris; it forms as part of the external folds of the labia minora and partially covers the clitorial glans and external shaft. There is considerable variation in how much of the glans protrudes from the hood and how much is covered by it, ranging from completely covered to fully exposed. Many textbooks describe the female prepuce as the only distal portion, the clitorial hood, but actually the prepuce in female is formed of three distinct parts: the base, which is in continuity proximally with mons pubis and cover the most proximal part of the clitoris, preputial body covering the shaft of the clitoris, and the term clitorial hood is reserved for the only cutaneous and nearly circular fold at the loose end of this prepuce.
Keywords
- Clitoris
- Hood
- Preputium of the clitoridis
- Frenulum of the clitoridis
- Labia minora
- Commissures
- Hoodplasty
This is a preview of subscription content, access via your institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsAbbreviations
- CAH:
-
Congenital adrenal hyperplasia
- DSD:
-
Disorders of sex development
- FGM:
-
Female genital mutilation
References
Robboy SJ, Bernhardt PF, Parmley T. Embryology of the female genital tract and disorders of abnormal sexual development. In: Blaustein’s pathology of the female genital tract. New York: Springer; 1994. p. 10e2.
Di Marino V, Lepidi H. Anatomic study of the clitoris and the bulbo-clitoral organ. Cham: Springer; 2014. https://doi.org/10.1007/978-3-319-04894-9_4.
Brodie KE, Grantham EC, Huguelet PS, Caldwell BT, Westfall NJ, Wilcox DT. Study of clitoral hood anatomy in the pediatric population. J Pediatr Urol. 2016;12:177.e1–5.
Chalmers DJ, O’Donnell CI, Casperson KJ, Bernard SC, Hou AH, Nuss GR, et al. Normal anatomic relationships in prepubescent female external genitalia. J Pediatr Urol. 2014;10(6):1117–21.
Ashton-Miller JA, De Lancey JOL. Functional anatomy of the female pelvic floor. Ann N Y Acad Sci. 2007;1101:266–96. https://www.scopus.com/inward/record.uri?eid=2-s2.0-
Ostrzenski A. The clitoral infrafrenulum fascial bundle. The anatomy and histology. Clin Anat. 2018;31:907–12. https://doi.org/10.1002/ca.23215.
Williams GL. The significance and function of preputial Langerhans cells. In: Oenniston GC, Hodges FM, Milos MF, editors. Male and female circumcision: medical, legal and ethical considerations in pediatric practice. 5th ed. New York: Kluwer Academic/Plenum Publishers; 1998. p. 43.
Patton DL, et al. Epithelial cell layer thickness and immune cell populations in the normal human vagina at different stages of the menstrual cycle. Am J Obstet Gynecol. 2000;183:967.
Harper WF, McNicol EM. A histological study of normal vulval skin from infancy to old age. Br J Dermatol. 1977;96:249.
Hodgins MB, Spike RC, Mackie RM, MacLean AB. An immunohistochemical study of androgen, oestrogen and progesterone receptors in the vulva and vagina. BJOG Int J Obstet Gynaecol. 1998;105:216–22. https://doi.org/10.1111/j.1471-0528.1998.tb10056.x.
Angier N. Woman: an intimate geography. New York: Houghton Mifflin Company; 1999. ISBN 0395691303
Puppo V. 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. Clin Anat. 2013;26:134–52.
Schober JM, Meyer-Bahlburg HF, Ransley PG. Self-assessment of genital anatomy, sexual sensitivity and function in women: implications for genitoplasty. BJU Int. 2004;94:589–94.
Bronselaer G, Callens N, De Sutter P, De Cuypere G, T’Sjoen G, Cools M, et al. Self-assessment of genital anatomy and sexual function within a Belgian, Dutch-speaking female population: a validation study. J Sex Med. 2013;10:3006–18.
Di Marino V, Lepidi H. Anatomic study of the clitoris and the bulbo-clitoral organ. Cham: Springer International; 2014. p. 13. https://doi.org/10.1007/978-3-319-04894-9_2.
Shih C, Cold CJ, Yang CC. Cutaneous corpuscular receptors of the human glans clitoris: descriptive characteristics and comparison with the glans penis. J Sex Med. 2013;10:1783.
Author information
Authors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Fahmy, M.A.B. (2020). Normal Female Prepuce. In: Normal and Abnormal Prepuce. Springer, Cham. https://doi.org/10.1007/978-3-030-37621-5_33
Download citation
DOI: https://doi.org/10.1007/978-3-030-37621-5_33
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-37620-8
Online ISBN: 978-3-030-37621-5
eBook Packages: MedicineMedicine (R0)