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The Clitoral Complex: The existence of the G-spot remains controversial partly because no appropriate structure and innervation have been clearly demonstrated in this pleasurable vaginal area. Using sonography, we wanted to visualize the movements of the clitoris and its anatomical relationship with the anterior wall of the vagina during voluntary perineal contraction and vaginal penetration without sexual stimulation. The aim of this presentation is to provide a dynamic sonographic study of the clitoris and to describe the movements of the quiescent clitoral complex during a voluntary perineal contraction. We aim to visualize the mechanical consequences of the pressure of the anterior vaginal wall with women who claim to have a special sensitivity of the G-spot area and vaginal orgasm. Histology and immunohistochemistry of the G-spot and other female genital tissues are beyond the scope of this study and have not been discussed. We used functional sonography of the quiescent clitoris with voluntary perineal contractions and with finger penetration without sexual stimulation. Main Outcome Measures. We focused on the size of the clitoris raphe, glans, and clitoral bodies and of the length of the movements of the clitoris during voluntary perineal contractions. The Female Sexual Function Index questionnaire results ranged from 27 to 32 showed no evidence of sexual dysfunction [9].

G-spot amplification is performed by attempting to locate the G-spot and noting measurements for future reference. After numbing the area with a local anesthetic, human engineered collagen is then injected directly under the mucosa in the area the G-spot is concluded to be in. The potential risks include sexual dysfunction, infection, altered sensation, dyspareunia , adhesions and scarring. They acquired the largest sample size of women to date — 1, — who are pairs of twins, and found that the twins did not report a similar G-spot in their questionnaires.

The research, headed by Tim Spector, documents a year study of the twins, identical and non-identical. According to the researchers, if one identical twin reported having a G-spot, it was more likely that the other would too, but this pattern did not materialize. It's telling people that there is a single, best way to have sex, which isn't the right thing to do.

Finding Your G-Spot

He stated, "Clitoral bulbs is an incorrect term from an embryological and anatomical viewpoint, in fact the bulbs do not develop from the phallus, and they do not belong to the clitoris. Because female fetal development is the "default" direction of fetal development in the absence of substantial exposure to male hormones and therefore the penis is essentially a clitoris enlarged by such hormones, Kilchevsky believes that there is no evolutionary reason why females would have two separate structures capable of producing orgasms and blames the porn industry and "G-spot promoters" for "encouraging the myth" of a distinct G-spot.

She stated that it "is best to think of the clitoris, urethra, and vagina as one unit because they are intimately related". When the research team asked several women to stimulate themselves in a functional magnetic resonance fMRI machine, brain scans showed stimulating the clitoris, vagina and cervix lit up distinct areas of the women's sensory cortex, which means the brain registered distinct feelings between stimulating the clitoris, the cervix and the vaginal wall — where the G-spot is reported to be.

However, for future improvement, it would be interesting to convince an ultrasound company to design and manufacture a clitoris probe: a light, small, microconvex, highfrequency, linear probe.

The cross-section of the clitoris was made possible by placing the probe transversally at the top of the vulva. The plane of the two clitoral bodies were well defined Figure 4A, B. They joined on the median line and formed the raphe Figure 5A, B. Anterior to the raphe, in the medium line, a lacunary and vascular structure was visualized: the glans Figures 3A and 4A. We began our functional studies by asking the patients to make voluntary pelvic contractions.

During the contractions, sonographic movements of the clitoris were demonstrated. On the coronal section, the clitoral bodies had a descending movement in our series.

The length of the movements ranged from 2. The decrease in the angle ranged from 13 to 87 Figure 6A, B. On the sagittal section, the clitoral body seemed to slide down Figure 7A, B while the raphe seemed to be pushed in an anterior direction. The angle between the clitoral body and the glans increased Figure 7A, B. On the cross-section, the two clitoral bodies seemed to telescope strongly pushing up the glans Figure 8A, B.

The raphe moved anteriorly. The length of the movement ranged from 1. The women were then asked to press with their fingers on their most pleasurable anterior vaginal area. We observed that the double vault of the clitoris was close to the area marked by the echogenicity of the finger [10]. The simple penetration of the finger created a perineal contraction reflex, which generated a movement of the double vault toward the finger marker Figure 10A, B.

With one volunteer, we reproduced the same effect with a sagittal plane, but with a different echoic marker wet tampon , because using the volunteer's finger as a vaginal marker of the sagittal view had revealed to be technically more difficult. On the sagittal scan, the root of the clitoris is seen descending and making contact with the anterior vaginal wall. This allows us to rule out the possibility of an artefact, because coronal and sagittal plane were coherent: there was an increasing proximity between the root of the clitoris and the so called "G-spot" Figure Figure 1 AC Coronal section of the root of the clitoris.

Ultrasound demonstrated that under a perineal contraction, the five components of the clitoris glans, raphe, bodies, crura, and bulb move in a certain way. The vaginal distension by penetration creates genital reflexes, which are the contraction of the pelvic muscles contractions of the bulbocavernosus and ischiocavernosus striated muscles.

This was termed "vaginocavernosus reflex," and it was demonstrated that the magnitude of contraction increases with the volume of vaginal inflation [13]. If the reflex perineal pelvic contractions narrowed the vaginal orifice [13], it also generated a descending movement of the clitoris [10]. Shafik hypothesized that during pelvic contraction, the fibers crossing over the dorsum of the clitoris potentiate glans' erection through compression of the dorsal vein of the clitoris, and through compression of the corpus and bulbous erectile tissue [13], however, except for the angle modification, we did not notice changes in the measurement of the glans during a contraction Figure 9A, B.

Ultrasound also permits visualization of the clitoris during vaginal penetrationa more difficult feat with an MRI. The patient located her own G-spot with her finger, the echoes of the finger were found at close proximity to the clitoris root, and the pressure movement of the finger displaced the clitoris. A reflex or a voluntary pelvic contraction, subsequent to a vaginal penetration, generates a series of neuromuscular mechanisms that bring the root of the clitoris closer to the G-spot.

With erotic stimulation [], neuromuscular reflex [13,17] and vasomotor events have been found. We suggest that these events could increase the contact between the vagina and the richly innervated and congestive clitoris.

The root of the clitoris internal clitoris could explain the pleasurable area of the G-spot. This fact is important because the poor innervation of the vagina is the usual argument for those who have denied the existence of the G-Spot. Thus D'amati et al. Pauls et al. MRI studies did not demonstrate periurethral tissues in signal intensity or size with arousal; consequently, Maravilla did not confirm this area as the G-spot [19,20]. In our small series, no glandular structure Skene's gland or prostatic structure surrounding the urethra was visualized, but the studies were practiced without sexual stimulation, and it might be possible that the Skene's ducts were not seen because of the absence of an anechoic amount of expelled fluid.

Wimpissinger et al. From the Trade Paperback edition.

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The G‐spot - Female Genital Plastic and Cosmetic Surgery - Wiley Online Library

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