Pauls Rachel, Mutema George, Segal Jeffrey, Silva W Andre, Kleeman Steven, Dryfhout Vicki, Karram Mickey
Division of Urogynecology and Reconstructive Pelvic Surgery, Good Samaritan Hospital, Cincinnati, OH.
Department of Pathology, Good Samaritan Hospital, Cincinnati, OH.
J Sex Med. 2006 Nov;3(6):979-987. doi: 10.1111/j.1743-6109.2006.00325.x.
Women possess sufficient vaginal innervation such that tactile stimulation of the vagina can lead to orgasm. However, there are few anatomic studies that have characterized the distribution of nerves throughout the human vagina.
The aim of this prospective study was to better characterize the anatomic distribution of nerves in the adult human vagina. A secondary aim was to assess whether vaginal innervation correlates with the subject's demographic information and sexual function.
Full-thickness biopsies of anterior and posterior vagina (proximal and distal), cuff, and cervix were taken during surgery in a standardized manner. Specimens were prepared with hematoxylin and eosin, and S100 protein immunoperoxidase. The total number of nerves in each specimen was quantified. Enrolled patients completed a validated sexual function questionnaire (Female Sexual Function Index, FSFI) preoperatively.
A description of vaginal innervation by location and an assessment of vaginal innervation in association with the subject's demographic information and sexual function.
Twenty-one patients completed this study, yielding 110 biopsy specimens. Vaginal innervation was somewhat regular, with no site consistently demonstrating the highest nerve density. Nerves were located throughout the vagina, including apex and cervix. No significant differences were noted in vaginal innervation based on various demographic factors, including age, vaginal maturation index, stage of prolapse, number of vaginal deliveries, or previous hysterectomy. There were no correlations between vaginal nerve quantity and FSFI domain and overall scores. Fifty-seven percent of the subjects had female sexual dysfunction; when compared to those without dysfunction, there were no significant differences in total or site-specific nerves.
In a prospective study, vaginal nerves were located regularly throughout the anterior and posterior vagina, proximally and distally, including apex and cervix. There was no vaginal location with increased nerve density. Vaginal innervation was not associated with demographic information or sexual function.
女性阴道具有足够的神经支配，以至于对阴道的触觉刺激可导致性高潮。然而，很少有解剖学研究描述人类阴道内神经的分布情况。
这项前瞻性研究的目的是更好地描述成年女性阴道内神经的解剖分布。次要目的是评估阴道神经支配与受试者的人口统计学信息及性功能之间是否存在关联。
在手术过程中，以标准化方式获取阴道前壁和后壁（近端和远端）、袖口和宫颈的全层活检组织。标本用苏木精和伊红以及S100蛋白免疫过氧化物酶进行处理。对每个标本中的神经总数进行量化。入选患者在术前完成一份经过验证的性功能问卷（女性性功能指数，FSFI）。
按位置描述阴道神经支配情况，并评估阴道神经支配与受试者的人口统计学信息及性功能之间的关系。
21名患者完成了本研究，共获得110份活检标本。阴道神经支配情况较为规律，没有一个部位始终显示出最高的神经密度。神经分布于整个阴道，包括顶端和宫颈。基于年龄、阴道成熟指数、脱垂阶段、阴道分娩次数或既往子宫切除术等各种人口统计学因素，阴道神经支配情况没有显著差异。阴道神经数量与FSFI各领域及总分之间没有相关性。57%的受试者存在女性性功能障碍；与无性功能障碍的受试者相比，神经总数或特定部位的神经数量没有显著差异。
在一项前瞻性研究中，阴道神经在前阴道和后阴道的近端和远端均有规律分布，包括顶端和宫颈。没有神经密度增加的阴道部位。阴道神经支配与人口统计学信息或性功能无关。
