Research Group for Sexology, University of Catania, Catania, Italy.
J Sex Med. 2011 Jun;8(6):1675-85. doi: 10.1111/j.1743-6109.2011.02253.x. Epub 2011 Apr 7.
There has never been an investigation about the in vivo clitoral structure.
To study the "in vivo" age-related structural changes of the clitoris in healthy women and in those affected by metabolic disorders.
Forty-three women subgrouping in (i) five teenagers, aged 14-18; (ii) eight young premenopausal women, aged 23-32; (iii) 10 premenopausal women, aged 38-47; (iv) nine diabetic premenopausal women, aged 27-43; and (v) 11 naturally postmenopausal women aged 51-55. Each woman underwent microbiopsy of the clitoral body by means of an 18G needle, length 100 mm, using a semiautomatic gun during total anesthesia for a benign gynecological pathology. The tissue removed was processed for electron microscopy. A morphometric procedure was used on electron micrographs.
Micro ultrastructure observation of clitoral tissue.
The cavernous tissue from the teenagers and young women showed large amounts of smooth muscle cells (SMCs). The intercellular connective tissue showed scanty, small isometric collagen fibers and amorphous extracellular matrix. In the premenopausal diabetic women, ultrastructural abnormalities of SMCs were observed, consisting of increase of glycogen deposits, infolding cell borders, and cytoplasmic vacuoles. Moreover, the intercellular connective tissue was increased by densely packed collagen fibers. Finally, in the healthy, natural postmenopausal women, the SMCs were moderately reduced in number. We observed age-related structural changes of the vascular spaces and of the vascular lacunae. The SMC mean thickness was reduced with age; vascular abnormalities appeared to be correlated with the presence of metabolic diseases, such as diabetes.
Our "in vivo" study could help to understand some aspects of the physiology of the clitoris and its role in sexual response. Apart from data obtained by studying healthy women and women affected by diabetes, other investigations are needed to study subgroups of otherwise healthy sexually dysfunctional women.
目前尚无关于活体阴蒂结构的研究。
研究健康女性和代谢紊乱女性活体阴蒂的“年龄相关”结构变化。
43 名女性分为五组：（i）14-18 岁的 5 名青少年；（ii）23-32 岁的 8 名年轻绝经前女性；（iii）38-47 岁的 10 名绝经前女性；（iv）27-43 岁的 9 名糖尿病绝经前女性；（v）51-55 岁的 11 名自然绝经后女性。每位女性均在全身麻醉下因良性妇科疾病使用半自动枪通过 18G 长 100mm 的针头对阴蒂体进行微创活检。取出的组织用于电子显微镜检查。对电子显微镜图像进行形态计量程序。
阴蒂组织的微观超微结构观察。
青少年和年轻女性的海绵组织显示大量平滑肌细胞（SMC）。细胞间结缔组织显示少量小等距胶原纤维和无定形细胞外基质。在绝经前糖尿病女性中，观察到 SMC 的超微结构异常，包括糖原沉积增加、细胞边界内陷和细胞质空泡。此外，细胞间结缔组织由密集排列的胶原纤维组成。最后，在健康的自然绝经后女性中，SMC 的数量适度减少。我们观察到血管空间和血管腔的年龄相关结构变化。SMC 的平均厚度随年龄而降低；血管异常似乎与代谢疾病（如糖尿病）的存在相关。
我们的“体内”研究有助于了解阴蒂生理学的某些方面及其在性反应中的作用。除了通过研究健康女性和糖尿病女性获得的数据外，还需要进行其他研究以研究其他健康性功能障碍女性的亚组。
