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The Anatomy of the Distal Vagina: Towards Unity


Helen E. O'Connell, MD, MMed, MBBS, FRACS (Urol), Clinical Associate Professor, Head of NeuroUrology and Continence Unit, Department of Surgery (Urology), Royal Melbourne Hospital, Parkville 3050, Victoria, Australia. Tel: +61 3 9342 7294; Fax: +61 3 9342 8928; E-mail: helen.o'


Introduction.  Factual presentations of sexual anatomy are required for educational purposes, for clinical and more general communication about sexual matters. To date, unambiguous, accurate and objective images with appropriate labeling to enhance specificity in communication have been lacking.

Aim.  The aim of this presentation is to provide a comprehensive overview of anatomy of the distal vagina. We aim to simplify the anatomy to reduce the confusion of historical descriptions. In doing so, we aim to avoid sacrificing any of the specific detail. This would aid communication between clinicians, researchers, and the nonclinician regarding this anatomy.

Outcome Measures and Methods.  This article reviews the historical and current anatomical literature. Systematic dissection and photography, histological study, and magnetic resonance imaging have been used as the basis for this presentation. Digital technology has been used to label, color, and highlight photography to provide clarity and permit diagramatization of photography. No distortion has otherwise been used in presenting images from cadavers or anatomical research.

Results.  The anatomy of the distal vagina and surrounding structures is shown and described in detailed. The distal vagina, clitoris, and urethra form an integrated entity covered superficially by the vulval skin and its epithelial features. These parts have a shared vasculature and nerve supply and during sexual stimulation respond as a unit though the responses are not uniform.

Conclusions.  Significant progress has been made in the field of female sexual anatomy and its pictorial representation. This may facilitate further progress in the related fields of female sexual health and education. O'Connell HE, Eizenberg N, Rahman M, and Cleeve J. The anatomy of the distal vagina: Towards unity. J Sex Med 2008;5:1883–1891.

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