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Beyond the Gspot: clitourethrovaginal complex anatomy in female orgasm
Emmanuele A.Jannini, Odile Buisson and Alberto Rubio-Casillas
Abstract | The search for the legendary, highly erogenous vaginal region, the Grfenberg spot (G-spot), has produced important data, substantially improving understanding of the complex anatomy and physiology of sexual responses in women. Modern imaging techniques have enabled visualization of dynamic interactions of female genitals during self-sexual stimulation or coitus. Although no single structure consistent witha distinct G-spot has been identified, the vagina is not a passive organ but a highly dynamic structure with an active role in sexual arousal and intercourse. Theanatomical relationships and dynamic interactions between the clitoris, urethra, and anterior vaginal wall have led to the concept of a clitourethrovaginal (CUV) complex, defininga variable, multifaceted morphofunctional area that, when properly stimulated during penetration, could induce orgasmic responses. Knowledge of the anatomy and physiology of the CUV complex might help to avoid damage to its neural, muscular, andvascular components during urological and gynaecological surgical procedures.
Jannini, E. A. etal. Nat. Rev. Urol. 11, 531538 (2014); published online 12 August 2014; http://www.nature.com/doifinder/10.1038/nrurol.2014.193
Web End =doi:10.1038/nrurol.2014.193
Introduction
As a relatively well-defined and exact field of biomedicine, gross anatomy rarely provides opportunities for controversial disagreements over hypotheses; however, the anatomy of the organs, tissues, and structures involved in the subjective orgasmic experience in women seems to be an exception. For experts in sexual medicine and specifically andrologists, urologists, gynaecologists, and urogynaecologists with a necessary interest in female orgasmic function as well as the related clinical and surgical aspects, the current nomenclature and, consequently, the taxonomy, represent important areas of contention. Whereas a single male type of orgasm is classically recognized, at least two distinct varieties of orgasms are described in women.1 The first type of female orgasm is obtained through the direct stimulation of the external clitoris, without any kind of internal stimulation. Herein, we refer to this orgasm as the clitorally activated orgasm (CAO). The second form of orgasm is described as that obtained during vaginal penetration
and in the absence of direct stimulation of the external clitoris:2 we proposed to name this type the vaginally activated orgasm(VAO).
The anatomical structures that might provoke VAOs rather than CAOs have not been completely and unequivocally described, probably...