Clit of a pussy

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From: Urologic Clinics of North America, The clitoris includes the erectile bodies paired bulbs and paired corpora, which are continuous Clit of a pussy the crura and the glans clitoris 2. The clitoris becomes engorged and highly sensitive during sexual activity. Traditionally it was believed to be innervated by the pudendal nerve; however, there are branches of the ilioinguinal and genitofemoral nerves which lie close to the clitoris and most likely are involved with clitoral sensation, too.

Histologic evaluation of clitoral tissue reveals erectile tissue and venous channels that are surrounded by smooth muscle. The anatomy of the clitoris has been studied using unenhanced magnetic resonance imaging MRI 3,4. In the study by O'Connell and DeLancey 3clitoral anatomy was shown most clearly in the axial plane. The sagittal and coronal planes are complementary to the axial plane. The bulbs of the clitoris are not well described in anatomical textbooks. MRI clearly shows the extensive relationship between the urethra and bulbs, and also reveals how these structures are intimately related to the crura and corpora forming the root of the Clit of a pussy.

The exact role that the bulbs play in urethral support and sexual function is unclear. In some cases the clitoris can become anatomically enlarged. Clitoromegaly is demonstrated in Figure The external genital muscles are located anteriorly in the UG triangle, whereas the anal sphincter complex and perineal body are in the anal triangle. The perineal body is a thickened, midline condensation of fibrous tissue at the midpoint of a line ing the ischial tuberosities.

At this point, several important muscles converge and are attached: The external anal sphincter, paired bulbospongiosus muscles, paired superficial transverse perineal muscles, and fibers of the levator ani. Axial oblique T2WI MR in a female patient at the level of the superficial external genital muscle shows the convergence of structures at the perineal body, which appears as a thickening of tissue in the midline. Levin, in Encyclopedia of Forensic and Legal Medicine The exposed external clitoris represents only a small part of the total erotic clitoral tissue, most of which is internal and hidden.

The superficial parts consist of the midline shaft 2—4 cm long, 1—2 cm wide comprising the corpora cavernosa capped by the clitoral glans 2—3 mm long at the normally exposed extremity. The shaft bifurcates internally into two curved crura 5—9 cm long while on either side of the vagina are two vaginal vestibular bulbs 3—7 cm long that are part of the corpus spongiosum of the clitoris.

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The triangular mucous membrane area surrounding the urethral meatus extending from the upper margin of the introitus to just below the clitoral glans has been called the periurethral glans. It is described as part of the female corpus spongiosum tissue and it actually has a strand that continues upwards toward the clitoris, ending as its glans. On effective sexual arousal the clitoral tissue becomes enlarged and engorged with blood, effected by the two neurotransmitters VIP and NO that dilate the blood supply to the organ.

The enhanced blood flow and congestion make the shaft and especially the clitoral glans extremely sensitive to erotic caresses and these, when applied, give intense pleasure. How important the crura and vestibular bulbs are to the generation of coital sexual pleasure is not known. The internal genitalia consist of the vagina, uterus, and cervix and the anterior vaginal wall erotic complex urethra, paraurethral glands G-spot? Attempts at managing the enlarged clitoris in genetic females with clitoral hypertrophy started with total clitorectomy.

Young originally advocated this procedure.

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Later, Lattimer suggested a recession rather than a resection of the clitoris, and he hoped to be able to preserve the arousal function of the clitoris. This led to cases in which painful clitoral erections occurred later in life; therefore, further modification was needed.

InSpence and Allen advocated the preservation of the glands with reduction in the size of the clitoris. Kogan and Snyder and their colleagues separately described a similar approach in which the erectile tissue of the clitoris is removed but preservation of the neurovascular bundle and the glands is afforded to preserve the neurologic and arousal functions of the clitoris. If, however, the gland is unusually large in size, then a reduction of the gland size may be indicated as well.

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The unfused portions of the ducts give rise to the fallopian tubes. The distal part of the vagina forms from invagination of a solid mass of cells between the uterovaginal canal and the urogenital sinus. Other parts of the urogenital sinus form the bladder, urethra, and vestibule.

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Accessory glands derived from the urethra are inconspicuous in most female fetuses as urethral and periurethral glands, whereas these develop into the prostate gland in male fetuses. These patients often have a clitoris -like phallus, severely bifid scrotum, and perineoscrotal hypospadias. Some patients have less severe genital ambiguity. Other findings are normal Wolffian structures, cryptorchidism, and a rudimentary prostate. The treatment of this enzyme deficiency is unclear when it is diagnosed in infancy. Male gender asment has been recommended because the natural history of this deficiency is virilization at puberty with subsequent change to male gender.

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However, this decision requires surgical hypospadias repair and orchiopexy with male hormonal replacement. At puberty, the s of virilization are increased muscle mass, deepening of voice, substantial growth of phallus, rogation, and hyperpigmentation of the scrotum, and normal libido.

They do not have gynecomastia or male pattern balding, facial hair is decreased, and their prostate remains infantile. Although these patients are usually oligo- or azoospermic, fertility can occur via intrauterine insemination. These patients are often raised as girls but adopt a male gender role at puberty. Therefore, they should be reared as males, if possible. DHT cream is applied to the genitals to induce growth of the phallus and facilitate hypospadias repair.

DHT cream may also increase facial and body hair growth in adulthood. Early correction of cryptorchidism may theoretically preserve fertility. Psychiatric counseling and parental reassurance that their child will have a normal male puberty is also Clit of a pussy.

Rodolfo A. Maguelone G. Forest, in Endocrinology Sixth Edition Classically, even in subjects born with a clitoris -like penis, bifid scrotum, and severe hypospadias, the penis enlarges at puberty with ificant muscular development. If recognized early, infants can now be treated specifically with DHT and may respond well.

In such patients, further virilization can be expected at puberty, and fertility is possible. Reports have described patients who were raised as females and who underwent a reversal of gender role behavior and married at adolescence, mainly in isolated communities, where the condition is more frequent. Marta R. Bizic, Miroslav L. Djordjevic, in Comprehensive Care of the Transgender Patient The simple metoidioplasty is performed on the hormonally hypertrophied clitoris. The skin around the clitoral corona is circumferentially incised, followed by degloving of the clitoral body and transection of the suspensory ligaments.

The urethral plate is dissected by oblique incisions to move the clitoris more anteriorly. The chordae are divided transversely with electrocautery and the base of the shaft is bulked and closed vertically with interrupted absorbable suture. The subcutaneous labial skin is further attached to the shaft along the corpora until the corona is reached. The degloved corona is reattached to the labia minora skin. In the end, the external surface of the labia minora skin is closed in the midline to reconstruct the ventral skin of the neophallus.

Since the native urethral opening stays intact, care must be taken to gauge how low the midline closure is, in order to allow for adequate urine outflow. A Foley catheter is placed to avoid urine contact with the suture lines. Complications associated with simple metoidioplasty are rare and usually are related to the incisional closure.

The procedure is an almost complication-free genital confirmation surgery option for patients that can be done as an outpatient procedure with minimal recovery. Congenital adrenal hyperplasia CAH is most common cause — Adrenal glands may be normal or enlarged.

Anuja Jhingran, Arlan F. Fuller Jr. Direct extension occurs to adjacent structures including the vagina, perineum, clitorisand anus. The vulva is richly supplied with lymphatic vessels that often cross Clit of a pussy midline. The lymphatics of the vulva consist of a network that covers the entire labia minora, fourchette, prepuce, and distal vagina below the hymenal membrane.

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These coalesce anteriorly, forming larger trunks that run laterally to the clitoris to the mons veneris, acquiring Clit of a pussy from the lymphatics of the labia majora, which run in a parallel fashion anteriorly from the perineal body.

The vulvar lymphatics run through the vulva and do not cross the labiocrural fold. The lymphatics of the perineum, however, course lateral to the labiocrural fold through the superficial tissues of the upper medial thigh. In the treatment of patients with advanced vulvar cancer that extends beyond the vulva to the perineal skin, these more lateral channels must be taken into consideration.

Similarly, direct proximal extension of an advanced vulvovaginal cancer along the vaginal cylinder may spread through vaginal lymphatics directly to pelvic nodes. At the mons veneris, the vulvar lymphatic trunks diverge laterally to the primary regional nodes, the ipsilateral or contralateral inguinal nodes. Study of the localization of dye or radiolabeled tracer in regional lymph nodes after focal injection of discrete sites in the vulva and on the perineum reveals that the lymphatic drainage of the perineum, clitoris, and anterior labia minora is bilateral, whereas the lymph flow from well-lateralized sites in the vulva is, predominantly, to the ipsilateral groin.

From the superficial inguinal nodes, secondary lymphatic drainage is through the cribriform fascia to the femoral nodes Fig. However, metastases have been reported to the femoral lymph nodes without involvement of the superficial inguinal lymph nodes, especially from carcinomas of the clitoris and Bartholin gland. The frequency of lymph node metastases to the inguinofemoral nodes is related to the lesion size and depth of stromal invasion. Hematogenous spread is rare in the absence of inguinofemoral lymph node involvement and usually occurs late in the course of the disease.

Download as PDF. Set alert. About this. Vulvar Anatomy Hope Haefner, in Obstetric and Gynecologic Dermatology Third EditionClitoris The clitoris includes the erectile bodies paired bulbs and paired corpora, which are continuous with the crura and the glans clitoris 2. View chapter Purchase book. Levin, in Encyclopedia of Forensic and Legal MedicineClitoris The exposed external clitoris represents only a small part of the total erotic clitoral tissue, most of which is internal and hidden. Ambiguous Genitalia in the Newborn Gregory Goodwin, Anthony Caldamone, in Avery's Diseases of the Newborn Eighth EditionClitoral Reduction Attempts at managing the enlarged clitoris in genetic females with clitoral hypertrophy started with total clitorectomy.

Forest, in Endocrinology Sixth EditionManagement Classically, even Clit of a pussy subjects born with a clitoris -like penis, bifid scrotum, and severe hypospadias, the penis enlarges at puberty with ificant muscular development. Djordjevic, in Comprehensive Care of the Transgender PatientSimple metoidioplasty The simple metoidioplasty is performed on the hormonally hypertrophied clitoris.

Clit of a pussy

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