PCOS and urethrovaginal space: 3-D volumetric and vascular analysis.
BACKGROUND
The vaginal orgasm seems to be evocated by the stimulation of the G-spot: a highly sensitive area on the anterior wall of the human vagina. However, the existence of such a spot is controversial.


OBJECTIVE
To evaluate, by the use of three-dimensional (3-D) ultrasonography, the anatomic structures of the urethrovaginal space both in polycystic ovarian syndrome (PCOS) patients and eumenorrheic non-hirsute controls.


METHODS
Twenty-three (Group I) PCOS patients and 25 eumenorrheic young women (Group II) were submitted to two-dimensional (2-D) and 3-D ultrasonography and color Doppler analysis of the urethrovaginal space and of the clitoris.


METHODS
2-D ultrasonographic evaluation of the ovaries and of the urethrovaginal space; color Doppler evaluation of the ovarian stromal arteries, urethrovaginal main feeding artery, and dorsal clitoral arteries; 3-D volume calculation of the urethrovaginal space, and 3-D power Doppler analysis of the vascularization index; flow index; and vascularization flow index; hormonal evaluation.


RESULTS
The vaginal orgasm was present in 13/23 (56%) patients in PCOS Group and in 13/25 (52%) in the controls. The 3-D reconstruction of the urethrovaginal space demonstrated a gland-like aspect with small feeding vessels: "female prostate." The 3-D mean volume of the "female prostate" was significantly higher in Group I (0.48 ± 0.21 mL) than in Group II (0.39 ± 0.19 mL; P = 0.044). The Virtual Organ Computer-aided AnaLys (VOCAL) built mean volume of the "female prostate" was positively correlated with the time since intercourse (r = 0.486; P = 0.032), with the total length of the urethrovaginal space (r = 0.616; P = 0.025) and with the testosterone (r = 0.424; P = 0.048) circulating values.


CONCLUSIONS
The presence of the G-spot and its role in vaginal orgasm remains controversial. In Italians, and normal weight PCOS patients the hyperandrogenism seems to result in ovarian stromal and "female prostate" hyperplasia.
Battaglia
Cesare
C
Department of Gynecology and Pathophysiology of Human Reproduction, Alma Mater Studiorum-University of Bologna, Italy. cesare.battaglia@unibo.it
Nappi
Rossella Elena
RE
Mancini
Fulvia
F
Alvisi
Stefania
S
Del Forno
Simona
S
Battaglia
Bruno
B
Venturoli
Stefano
S
D000293:Adolescent; D000328:Adult; D001158:Arteries / Q000000981:diagnostic imaging; D001783:Blood Flow Velocity / Q000502:physiology; D002987:Clitoris / Q000098:blood supply* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D009948:Orgasm / Q000502:physiology*; D011085:Polycystic Ovary Syndrome / Q000000981:diagnostic imaging* / Q000503:physiopathology; D012016:Reference Values; D012039:Regional Blood Flow / Q000502:physiology; D013739:Testosterone / Q000097:blood; D018615:Ultrasonography, Doppler, Color; D014521:Urethra / Q000098:blood supply* / Q000000981:diagnostic imaging*; D014621:Vagina / Q000098:blood supply* / Q000000981:diagnostic imaging*; D055815:Young Adult
D013739:Testosterone