Self-assessment of genital anatomy, sexual sensitivity and function in women: implications for genitoplasty
Article first published online: 25 AUG 2004
Volume 94, Issue 4, pages 589–594, September 2004
How to Cite
Schober, J. M., Meyer-Bahlburg, H. F.L. and Ransley, P. G. (2004), Self-assessment of genital anatomy, sexual sensitivity and function in women: implications for genitoplasty. BJU International, 94: 589–594. doi: 10.1111/j.1464-410X.2004.05006.x
- Issue published online: 25 AUG 2004
- Article first published online: 25 AUG 2004
- Accepted for publication 26 May 2004
- genital anatomy;
- sexual sensitivity;
- sexual function
Authors from the USA and UK evaluate female patients’ perception of genital anatomy, and estimate the implications of this for genitoplasty. There are several important observations by the people who completed the questionnaire which should lead surgeons who perform genitoplasty to remember the functional aspects as well as the anatomical appearance after this operation.
To assess the perceptions of healthy women of their genital anatomy and sexual sensitivity, and to provide suggestions for genitoplasty based on this information, as the success of genitoplasty has historically relied upon the surgeon's perception of the patient's anatomy and function, rather than the patient's perception of outcome in terms of appearance and erotic sensitivity.
SUBJECTS AND METHODS
Fifty healthy, sexually active, adult women (aged 20–56 years) with no history of genital surgery completed the female version of the Self-Assessment of Genital Anatomy and Sexual Function. This self- report questionnaire comprises written text and images enabling women to rate the appearance, size and position of clitoris and vagina, as well as the intensity of orgasm and effort required for achieving orgasm in specified areas around the clitoris and within the vagina. Anatomical locations were compared for these ratings by repeated-measures analysis of variance.
Anatomically, 46% of women described their clitoris as ‘moderate-sized and raised’, 42% as ‘small and raised’, and 78% reported that their vaginal opening was adequate for sexual penetration. The women reported the strongest orgasm and least effort to obtain an orgasm with stimulation of the area on and above the clitoris. For vaginal sensitivity, scores for orgasm intensity increased, and for orgasm effort decreased, with increasing vaginal depth, and they indicated less sexual sensitivity for the vagina than for the external genitalia.
The skin above the clitoris, and the clitoris itself, appeared to be the most sexually sensitive. During genitoplasty, attention to preserving skin-flap integrity in this area seems appropriate.