title: Normal anatomic relationships in prepubescent female external genitalia.
abstract: OBJECTIVE
  Female congenital abnormalities and concomitant ambiguous genitalia constitute the primary reason for female genital reconstruction, however, objective data describing normal female anatomy is lacking. The aim of this study is to describe the normal anatomical relationships and size of the external genital structures in prepubescent females.
  
  
  METHODS
  Data were collected prospectively from consecutive Tanner stage 1 females undergoing surgery unrelated to the genitalia. Recorded measurements included: clitoris length and width, length from clitoris to anus, clitoris to urethra, clitoris to posterior labia majora, mucosa behind vagina or posterior fourchette, and radius to labia minora at vagina. Patients were stratified by age into four age groups: <2 years, 2-5 years, 5-11 years and >11 years.
  
  
  RESULTS
  Fifty-six patients met inclusion criteria. Clitoral width was similar in all age groups. The regression plots for the remaining measurements modeled on age all show a significant linear growth distribution.
  
  
  CONCLUSIONS
  The average clitoral width was 3.8 mm, which remained constant between age groups. Clitoral length, length from clitoris to anus, clitoris to posterior labia majora, clitoris to urethra and posterior fourchette length increased across age groups. This study provides insight into the dimensions of normal external genitalia in tanner stage 1 females.
authors: Children's Hospital Colorado, 13123 E. 16th Ave, 463 Aurora, CO 80045, USA. Electronic address: dchalmers55@gmail.com.
authors: David J
authors: DJ
authors: Chalmers
authors: University of Colorado-Denver, Tivoli Student Union Suite 124, 900 Auraria Parkway, Denver, CO 80204, USA. Electronic address: Colin.ODonnell@ucdenver.edu.
authors: Colin I
authors: CI
authors: O'Donnell
authors: Children's Hospital Colorado, 13123 E. 16th Ave, 463 Aurora, CO 80045, USA. Electronic address: kellycasperson@gmail.com.
authors: Kelly J
authors: KJ
authors: Casperson
authors: University of Colorado, Anschutz Medical Center, 13001 E 17th Place, Aurora, CO 80045, USA. Electronic address: samuel.berngard@ucdenver.edu.
authors: Samuel C
authors: SC
authors: Berngard
authors: Children's Hospital Colorado, 13123 E. 16th Ave, 463 Aurora, CO 80045, USA. Electronic address: amy.h.chen@gmail.com.
authors: Amy H
authors: AH
authors: Hou
authors: University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. Electronic address: geoffrey-nuss@fsm.northwestern.edu.
authors: Geoffrey R
authors: GR
authors: Nuss
authors: Children's Hospital Colorado, 13123 E. 16th Ave, 463 Aurora, CO 80045, USA. Electronic address: nicholas.cost@childrenscolorado.org.
authors: Nicholas G
authors: NG
authors: Cost
authors: Children's Hospital Colorado, 13123 E. 16th Ave, 463 Aurora, CO 80045, USA. Electronic address: duncan.wilcox@childrenscolorado.org.
authors: Duncan T
authors: DT
authors: Wilcox
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D005836:Genitalia, Female / Q000033:anatomy & histology*; D006801:Humans; D009929:Organ Size
keywords: Anatomy; Disorder of sex differentiation; Female; Genitalia; Prepubescent; Tanner stage I