Schober Justine, Cooney Timothy, Pfaff Donald, Mayoglou Lazarus, Martin-Alguacil Nieves
Department of Neurobiology and Behavior, Rockefeller University, New York, New York, USA.
J Pediatr Adolesc Gynecol. 2010 Dec;23(6):352-7. doi: 10.1016/j.jpag.2010.03.009. Epub 2010 May 21.
Surgical and histologic sources of information give little reference to innervation, vascular, and epithelial details of the labia minora. Little is known about areas of nerve density, epithelial qualities, and vascular compartments of the labial minora that contribute to sexual arousal and orgasm. Surgical procedure development and counsel about surgical risks related to labioplasty and surgical flaps created from labial tissue may be based on inadequate information.
Labial samples from 10 normal girls (aged 2-9 years) who underwent surgery for labial fusion utilized waste tissue strips for immunohistochemical identification of S-100 and neuronal nitric oxide synthase (nNOS) in the labia minora.
Vascular and lymphatic plexus lie within the reticular dermis, which contains a dense mesh of nerve fibers with a higher concentration of nerve fiber at the level of the subepithelial plexus. Dense innervations are located at the epidermis, extending along the basal and spinous layers of the epithelium of labia minora. Nerve bundles in the papillary dermis are associated with sebaceous and eccrine glands and nerve terminals located throughout the epithelium. The introital epithelium of the labia minora is highly innervated with widespread and intense staining, detected in the introital border of the labia minora versus the external one. The dermis appeared to display S-100 and nNOS immunolabelling. S-100 was also immunopositive in the epidermis.
Labia minora is highly innervated along its entire edge. Related vascular compartment tissue involved in engorgement during sexual arousal makes this tissue important for sexual response. Labioplasty risks removal of tissue with an important contribution to sensory sexual arousal. Movement of labial tissue during genitoplasty may have different sensory outcomes dependent on which labial surface is used.
手术和组织学方面的信息很少提及小阴唇的神经支配、血管和上皮细节。对于小阴唇中有助于性唤起和性高潮的神经密度区域、上皮特征和血管腔室,人们了解甚少。阴唇整形手术的程序发展以及与阴唇整形术和由阴唇组织制成的手术皮瓣相关的手术风险咨询可能基于不充分的信息。
对10名接受阴唇融合手术的正常女孩(年龄2至9岁)的阴唇样本,利用废弃组织条对小阴唇中的S-100和神经元型一氧化氮合酶(nNOS)进行免疫组织化学鉴定。
血管和淋巴丛位于网状真皮内,其中含有密集的神经纤维网,在皮下丛水平神经纤维浓度更高。密集的神经支配位于表皮,沿着小阴唇上皮的基底层和棘层延伸。乳头真皮中的神经束与皮脂腺和汗腺以及遍布上皮的神经末梢相关。小阴唇阴道口上皮神经高度密集,染色广泛且强烈,在小阴唇阴道口边缘与外部边缘均可检测到。真皮似乎显示出S-100和nNOS免疫标记。S-100在表皮中也呈免疫阳性。
小阴唇在其整个边缘神经高度密集。在性唤起期间参与充血的相关血管腔室组织使该组织对性反应很重要。阴唇整形手术有去除对性感觉唤起有重要作用的组织的风险。在生殖器整形术中阴唇组织的移动可能会有不同的感觉结果,这取决于使用的是阴唇的哪一面。