title: Measurement of the thickness of the urethrovaginal space in women with or without vaginal orgasm.
abstract: BACKGROUND
  The physiology and anatomy of female sexual function are poorly understood. The differences in sexual function among women may be partly attributed to anatomical factors.
  
  
  OBJECTIVE
  The purpose of this study was to use ultrasonography to evaluate the anatomical variability of the urethrovaginal space in women with and without vaginal orgasm.
  
  
  METHODS
  Twenty healthy, neurologically intact volunteers were recruited from a population of women who were a part of a previous published study. All women underwent a complete urodynamic evaluation and those with clinical and urodynamic urinary incontinence, idiopathic detrusor overactivity, or micturition disorders, as well as postmenopausal women and those with sexual dysfunction were excluded. The reported experience of vaginal orgasm was investigated.
  
  
  METHODS
  The urethrovaginal space thickness as measured by ultrasound was chosen as the indicator of urogenital anatomical variability. Designated evaluators carried out the measurements in a blinded fashion.
  
  
  RESULTS
  The urethrovaginal space and distal, middle, and proximal urethrovaginal segments were thinner in women without vaginal orgasm. A direct correlation between the presence of vaginal orgasm and the thickness of urethrovaginal space was found. Women with a thicker urethrovaginal space were more likely to experience vaginal orgasm (r = 0.884; P = 0.015). A direct and significant correlation between the thickness of each urethrovaginal segment and the presence of vaginal orgasm was found, with the best correlation observed for the distal segment (r = 0.863; P < 0.0001). Interobserver agreement between the designated evaluators was excellent (r = 0.87; P < 0.001).
  
  
  CONCLUSIONS
  The measurement of the space within the anterior vaginal wall by ultrasonography is a simple tool to explore anatomical variability of the human clitoris-urethrovaginal complex, also known as the G-spot, which can be correlated to the ability to experience the vaginally activated orgasm.
authors.affiliation: Department of Experimental Medicine, University of L'Aquila, L'Aquila, Italy.
authors.forename: Giovanni Luca
authors.initials: GL
authors.lastname: Gravina
authors.forename: Fulvia
authors.initials: F
authors.lastname: Brandetti
authors.forename: Paolo
authors.initials: P
authors.lastname: Martini
authors.forename: Eleonora
authors.initials: E
authors.lastname: Carosa
authors.forename: Savino M
authors.initials: SM
authors.lastname: Di Stasi
authors.forename: Susanna
authors.initials: S
authors.lastname: Morano
authors.forename: Andrea
authors.initials: A
authors.lastname: Lenzi
authors.forename: Emmanuele A
authors.initials: EA
authors.lastname: Jannini
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007989:Libido; D009948:Orgasm / Q000502:physiology*; D010865:Pilot Projects; D012016:Reference Values; D012735:Sexual Dysfunction, Physiological / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D014521:Urethra / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D014621:Vagina / Q000033:anatomy & histology / Q000000981:diagnostic imaging*