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The role of clitoral topography in sexual arousal and orgasm: transperineal ultrasound study

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Abstract

Introduction and hypothesis

The clitoris has a critical pivotal role in female orgasm and arousal. The aim of this cross-sectional study was to evaluate topographic measurements of the clitoris, as well as to explore potential relationships between the clitoral complex and the orgasm domain of female sexual function, combining transperineal ultrasound with morphometric measurements.

Methods

In sexually active, heterosexual, premenopausal women, three-dimensional transperineal ultrasound imaging was used to measure the subpubic angle, the anterior triangle area (ATA) of the genital hiatus, the levator urethra gap, and the anteroposterior and transverse diameters of the genital hiatus. Mons pubis thickness, clitoris–urethra distance (CUD), clitoris–fourchette distance, and fourchette–perineal body distance were measured using a caliper. Comparison of measurements and correlation with orgasm score were performed.

Results

Among the 108 sexually active women, 30 (27.7 %) reported a low orgasm domain score. There were statistically significant differences between the low orgasm group and the control group in the ATA (4.05 vs 3.64 cm2 respectively; p = 0.03), CUD (21 mm; p = 0.04 vs 16.1 mm; p = 0.04), and volume of the glans clitoris (947.7 mm3 vs 1081 mm3; p = 0.02). There was a moderate and inverse correlation between clitoris–urethra distance and orgasm (r = −0.53, p < 0.001), and arousal (r = −0.42 p < 0.001). Broader ATA (OR = 0.47; 95 % CI = 0.23–0.99; p = 0.04) and longer CUD (OR = 0.57; 95 % CI = 0.44–0.73; p < 0.001) were identified as the only independent predictors of orgasm problems.

Conclusions

Longer glans clitoris–urethra distance and broad space for the deep structures of the clitoris is related to difficulty in reaching orgasm and arousal problems.

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Acknowledgements

The authors would like to thank the participants in the study.

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Authors and Affiliations

  1. Department of Urogynecology İstanbul, Koc University School of Medicine, İstanbul, Turkey

    Serdar Aydın

  2. Department of Obstetrics and Gynecology, Okmeydanı Research and Training Hospital, İstanbul, Turkey

    Neslihan Bademler

  3. Department of Obstetrics and Gynecology, Süleymaniye Maternity and Children’s Training and Research Hospital, İstanbul, Turkey

    Elif Aslı Sarıoğlu Yardımcı

  4. Department of Obstetrics and Gynecology, Medicalpark Goztepe Hospital, İstanbul, Turkey

    Çağrı Arıoğlu

  5. Department of Obstetrics and Gynecology, Bezmialem Vakif University, İstanbul, Turkey

    Ayşe Filiz Gökmen Karasu

Authors
  1. Serdar Aydın
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  2. Neslihan Bademler
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  3. Elif Aslı Sarıoğlu Yardımcı
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  4. Çağrı Arıoğlu
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  5. Ayşe Filiz Gökmen Karasu
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Contributions

S. Aydın: project development, data collection, manuscript writing, data analysis; N. Bademler: project development, data collection, data analysis; E.A.S Yardımcı: project development, data collection, data analysis. A. Çağrı: manuscript writing, data analysis, investigation; A.F.G. Karasu: data collection, manuscript writing, investigation.

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Correspondence to Serdar Aydın.

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Aydın, S., Bademler, N., Yardımcı, E.A.S. et al. The role of clitoral topography in sexual arousal and orgasm: transperineal ultrasound study. Int Urogynecol J 33, 1495–1502 (2022). https://doi.org/10.1007/s00192-021-04830-x

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  • DOI: https://doi.org/10.1007/s00192-021-04830-x

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