Innervation pattern and fiber counts of the human dorsal nerve of clitoris.


Journal

Scientific reports
ISSN: 2045-2322
Titre abrégé: Sci Rep
Pays: England
ID NLM: 101563288

Informations de publication

Date de publication:
04 Oct 2024
Historique:
received: 30 03 2024
accepted: 11 09 2024
medline: 5 10 2024
pubmed: 5 10 2024
entrez: 4 10 2024
Statut: epublish

Résumé

Even tough clitoris plays a critical role in female sexuality, we lack a precise understanding of qualitative and quantitative aspects of the innervation of the human clitoris. To address this issue, we dissected human clitorides from body donors and imaged them after staining with iodine with microCT for a macroscopic analysis. To resolve innervation patterns at the microscopic level we prepared thin sections of clitorides and stained them with trichrome azan to reveal the tissue structure combined with immunocytochemistry against Neurofilament H antibodies to reveal all axons and luxol blue labeling to reveal myelinated axons. We find the clitoral branch of pudendal nerve that innervates the clitoris not as single nerve, but as number of loose bundles. In the crus of the clitoris, about 12 such bundles can be recognized while about 32 bundles are present in the clitoral hemi-body. We counted on avarage 2917 axons in the crus of the clitoris (76% of which are myelinated) and 3137 axons in the hemibody of the clitoris (71% of which are myelinated). While the human clitoris receives only one third of the number of axons that innervate the human penis, an estimate of innervation density (per surface area) revealed that clitoris has approximately 6 times denser innervation compared to the penis. Thus, our study combines histology with microCT analysis provides detailed information on the number, myelination and innervation density of dorsal nerve of clitoris.

Identifiants

pubmed: 39367034
doi: 10.1038/s41598-024-72898-8
pii: 10.1038/s41598-024-72898-8
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

23060

Informations de copyright

© 2024. The Author(s).

Références

Cleghorn, E. Unwell women: Misdiagnosis and myth in a man-made world. Penguin (2022).
Kobelt, G. L. Die männlichen und Weiblichen Wollustorgane Des Menschen Und Einiger Säuethiere in anatomisch-pyhsiologischer Beziehung (Publ. Adolph Emmerling, 1844).
Freud, S. On sexuality: Three essays on the theory of sexuality and other works. Vol. 7 of The Pelican Freud Library. Trans. James Strachey. London: Penguin, 142 – 44. (1979).
Gross, R. E. Vagina Obscura: An Anatomical Voyage (WW Norton & Company, 2022).
Masters, W. H. & Johnson, V. E. (1966). Human sexual response.
O’Connell, H. E., Hutson, J. M., Anderson, C. R. & Plenter, R. J. Anatomical relationship between urethra and clitoris. J. Urol.159(6), 1892–1897. https://doi.org/10.1016/S0022-5347(01)63188-4 (1998).
doi: 10.1016/S0022-5347(01)63188-4 pubmed: 9598482
O’Connell, H. E., Eizenberg, N., Rahman, M. & Cleeve, J. The anatomy of the distal vagina: towards unity. J. Sex. Med.5(8), 1883–1891. https://doi.org/10.1111/j.1743-6109.2008.00875.x (2008).
doi: 10.1111/j.1743-6109.2008.00875.x pubmed: 18564153
Oakley, S. H. et al. Innervation and histology of the clitoral-urethal complex: a cross-sectional cadaver study. J. Sex. Med.10(9), 2211–2218. https://doi.org/10.1111/jsm.12230 (2013).
doi: 10.1111/jsm.12230 pubmed: 23809460
Pauls, R. N. Anatomy of the clitoris and the female sexual response. Clin. Anat.28(3), 376–384. https://doi.org/10.1002/ca.22524 (2015).
doi: 10.1002/ca.22524 pubmed: 25727497
Jannini, E. A., Buisson, O. & Rubio-Casillas, A. Beyond the G-spot: Clitourethrovaginal complex anatomy in female orgasm. Nat. Rev. Urol.11(9), 531–538. https://doi.org/10.1038/nrurol.2014.193 (2014).
doi: 10.1038/nrurol.2014.193 pubmed: 25112854
Puppo, V. Embryology and anatomy of the vulva: the female orgasm and women’s sexual health. Eur. J. Obstet. Gynecol. Reprod. Biol.154(1), 3–8. https://doi.org/10.1016/j.ejogrb.2010.08.009 (2011).
doi: 10.1016/j.ejogrb.2010.08.009 pubmed: 20832160
van Turnhout, A. A., Hage, J. J. & van Diest, P. J. The female corpus spongiosum revisited. Acta Obstet. Gynecol. Scand.74(10), 767–771. https://doi.org/10.3109/00016349509021194 (1995).
doi: 10.3109/00016349509021194 pubmed: 8533557
Shih, C., Cold, C. J. & Yang, C. C. The pars intermedia: an anatomic basis for a coordinated vascular response to female genital arousal. J. Sex. Med.10(6), 1526–1530. https://doi.org/10.1111/j.1743-6109.2012.02996.x (2013).
doi: 10.1111/j.1743-6109.2012.02996.x pubmed: 23157396
Tappy, E. E., Carrick, K. S., Ramirez, D. M., Sawyer, P. & Corton, M. M. Anatomic relationships of the clitoral body, bulbs of the vestibule, and urethra. Am. J. Obstet. Gynecol.228(6), 720–e1. https://doi.org/10.1016/j.ajog.2023.02.011 (2023).
doi: 10.1016/j.ajog.2023.02.011
Vaze, A. et al. Determining the course of the dorsal nerve of the clitoris. Urology. 72(5), 1040–1043. https://doi.org/10.1016/j.urology.2008.07.029 (2008).
doi: 10.1016/j.urology.2008.07.029 pubmed: 18817954
Kelling, J. A., Erickson, C. R., Pin, J. & Pin, P. G. Anatomical dissection of the dorsal nerve of the clitoris. Aesthet. Surg. J.40(5), 541–547. https://doi.org/10.1093/asj/sjz330 (2020).
doi: 10.1093/asj/sjz330 pubmed: 31768527
Moszkowicz, D. et al. Neural supply to the clitoris: Immunohistochemical study with three-dimensional reconstruction of cavernous nerve, spongious nerve, and dorsal clitoris nerve in human fetus. J. Sex. Med.8(4), 1112–1122. https://doi.org/10.1111/j.1743-6109.2010.02182.x (2011).
doi: 10.1111/j.1743-6109.2010.02182.x pubmed: 21269395
Jackson, L. A. et al. Anatomy, histology, and nerve density of clitoris and associated structures: clinical applications to vulvar surgery. Am. J. Obstet. Gynecol.221(5), 519–e1. https://doi.org/10.1016/j.ajog.2019.06.048 (2019).
doi: 10.1016/j.ajog.2019.06.048
Bundesland Berlin. Gesetz zur Regelung des Sektionswesens (Sektionsgesetz). Berlin: Bundesland Berlin. Zugänglich unter/ (1996). https://gesetze.berlin.de/bsbe/document/jlr-SRegGBErahmen
Bundesland Berlin. Gesetz über das Leichen- und Bestattungswesen (Bestattungsgesetz). Berlin: Bundesland Berlin. Zugänglich unter/ (1973). https://gesetze.berlin.de/bsbe/document/jlr-BestattGBErahmen
Tunçkol, E., Purkart, L., Eigen, L., Vida, I. & Brecht, M. Fiber counts and architecture of the human dorsal penile nerve. Sci. Rep.13(1), 8862. https://doi.org/10.1038/s41598-023-35030-w (2023).
doi: 10.1038/s41598-023-35030-w pubmed: 37258532 pmcid: 10232416
Suh, D. D., Yang, C. C., Cao, Y., Garland, P. A. & Maravilla, K. R. Magnetic resonance imaging anatomy of the female genitalia in premenopausal and postmenopausal women. J. Urol.170(1), 138–144. https://doi.org/10.1097/01.ju.0000071880.15741.5f (2003).
doi: 10.1097/01.ju.0000071880.15741.5f pubmed: 12796666
O’Connell, H. E., Sanjeevan, K. V. & Hutson, J. M. Anatomy of the clitoris. J. Urol.174, 1189–1195. https://doi.org/10.1097/01.ju.0000173639.38898.cd (2005).
doi: 10.1097/01.ju.0000173639.38898.cd pubmed: 16145367
Yang, C. C., Cold, C. J., Yilmaz, U. & Maravilla, K. R. Sexually responsive vascular tissue of the vulva. BJU Int.97(4), 766–772. https://doi.org/10.1111/j.1464-410X.2005.05961.x (2006).
doi: 10.1111/j.1464-410X.2005.05961.x pubmed: 16536770
Grafenberg, E. The role of the urethra in female orgasm. Int. J. Sexol. 3(2), 146 (1950).
Pastor, Z. & Chmel, R. Differential diagnostics of female sexual fluids: a narrative review. Int. Urogynecol. J.29, 621–629. https://doi.org/10.1007/s00192-017-3527-9 (2018).
doi: 10.1007/s00192-017-3527-9 pubmed: 29285596
Pastor, Z. Female ejaculation orgasm versus coital incontinence: a systematicreview. J. Sex. Med.10(7), 1682–1691. https://doi.org/10.1111/jsm.12166 (2013).
doi: 10.1111/jsm.12166 pubmed: 23634659
Cutillas-Blasco, S. et al. Experiences of young women in the practice of squirting: a descriptive qualitative study. J. Sex. Med.21(8), 691–699. https://doi.org/10.1093/jsxmed/qdae065 (2024).
doi: 10.1093/jsxmed/qdae065 pubmed: 38899734
Mota, R. L. Female urinary incontinence and sexuality. Int. Braz J. Urol.43, 20–28. https://doi.org/10.1590/S1677-5538.IBJU.2016.0102 (2017).
doi: 10.1590/S1677-5538.IBJU.2016.0102 pubmed: 28124522 pmcid: 5293379
Graziottin, A. & Gambini, D. Anatomy and physiology of genital organs - women. Handb. Clin. Neurol.130, 39–60. https://doi.org/10.1016/B978-0-444-63247-0.00004-3 (2015).
doi: 10.1016/B978-0-444-63247-0.00004-3 pubmed: 26003238
Longhurst, G. J. et al. Beyond the tip of the iceberg: a meta-analysis of the anatomy of the clitoris. Clin. Anat.37(2), 233–252. https://doi.org/10.1002/ca.24113 (2023).
doi: 10.1002/ca.24113 pubmed: 37775965
Halata, Z. & Munger, B. L. The neuroanatomical basis for the protopathic sensibility of the human glans penis. Brain Res.371(2), 205–230. https://doi.org/10.1016/0006-8993(86)90357-4 (1986).
doi: 10.1016/0006-8993(86)90357-4 pubmed: 3697758
Shih, C., Cold, C. J. & Yang, C. C. Cutaneous corpuscular receptors of the human glans clitoris: descriptive characteristics and comparison with the glans penis. J. Sex. Med.10(7), 1783–1789. https://doi.org/10.1111/jsm.12191 (2013).
doi: 10.1111/jsm.12191 pubmed: 23692408
Qi, L., Iskols, M., Handler, A. & Ginty, D. D. Krause corpuscles of the genitalia are vibrotactile sensors required for normal sexual behavior. bioRxiv. 2023–2006. https://doi.org/10.1101/2023.06.14.545006 (2023).
Uloko, M., Isabey, E. P. & Peters, B. R. How many nerve fibers innervate the human glans clitoris: a histomorphometric evaluation of the dorsal nerve of the clitoris. J. Sex. Med.20(3), 247–252. https://doi.org/10.1093/jsxmed/qdac027 (2023).
doi: 10.1093/jsxmed/qdac027 pubmed: 36763957
Connell, K. et al. Effects of age, menopause, and comorbidities on neurological function of the female genitalia. Int. J. Impot. Res.17(1), 63–70. https://doi.org/10.1038/sj.ijir.3901230 (2005).
doi: 10.1038/sj.ijir.3901230 pubmed: 15164089
Verdú, E., Ceballos, D., Vilches, J. J. & Navarro, X. Influence of aging on peripheral nerve function and regeneration. J. Peripher Nerv. Syst.5(4), 191–208. https://doi.org/10.1046/j.1529-8027.2000.00026.x (2000).
doi: 10.1046/j.1529-8027.2000.00026.x pubmed: 11151980
Yucel, S., de Souza, A. & Baskin, L. S. Neuroanatomy of the human female lower urogenital tract. J. Urol.172(1), 191–195. https://doi.org/10.1097/01.ju.0000128704.51870.87 (2004).
doi: 10.1097/01.ju.0000128704.51870.87 pubmed: 15201770
Hauser–Kronberger, C. et al. Peptidergic innervation of the human clitoris. Peptides. 20(5), 539–543. https://doi.org/10.1016/s0196-9781(99)00005-4 (1999).
doi: 10.1016/s0196-9781(99)00005-4 pubmed: 10465504
Peters, B., Ndumele, A. & Uloko, M. I. Clinical implications of the historical, medical, and social neglect of the clitoris. J. Sex. Med.20(4), 418–421. https://doi.org/10.1093/jsxmed/qdac044 (2023).
doi: 10.1093/jsxmed/qdac044 pubmed: 37002638
Mahar, E. A., Mintz, L. B. & Akers, B. M. Orgasm equality: scientific findings and societal implications. Curr. Sex. Health Rep.12(1), 24–32. https://doi.org/10.1007/s11930-020-00237-9 (2020).
doi: 10.1007/s11930-020-00237-9

Auteurs

Elçin Tunçkol (E)

Bernstein Center for Computational Neuroscience Berlin, Humboldt-Universität zu Berlin, Philippstrasse 13, Haus 6, Berlin, Germany.

Christine Heim (C)

Institute of Medical Psychology, Charité-Universitätsmedizin Berlin, Corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, 10117, Berlin, Germany.

Irene Brunk (I)

Institute for Integrative Neuroanatomy, Charité - Universitätsmedizin Berlin, CCM, Philippstrasse 12, 10115, Berlin, Germany.

Imre Vida (I)

Institute for Integrative Neuroanatomy, Charité - Universitätsmedizin Berlin, CCM, Philippstrasse 12, 10115, Berlin, Germany.

Michael Brecht (M)

Bernstein Center for Computational Neuroscience Berlin, Humboldt-Universität zu Berlin, Philippstrasse 13, Haus 6, Berlin, Germany. michael.brecht@bccn-berlin.de.
NeuroCure Cluster of Excellence, Humboldt-Universität zu Berlin, Berlin, Germany. michael.brecht@bccn-berlin.de.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female
Humans United States Aged Cross-Sectional Studies Medicare Part C
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH