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Neoclitoral location may affect sexual function in transgender women: a preliminary pelvic MRI study

International Journal of Impotence Research volume 36, pages 526–530 (2024)Cite this article

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Abstract

Assigned female at birth with anorgasmia possess a smaller clitoral glans and clitoral components farther from the vagina lumen than women with normal orgasmic function. There are no studies evaluating this correlation in operated transgender women. We evaluated whether differences in MRI measurements of neoclitoris volume and distance between the neoclitoris and the neovagina were correlated with differences in sexual function. We recruited for a prospective survey study 40 operated male to female patients (oMtF) who had undergone genital gender affirming surgery and postoperative pelvic MRI. Individual pelvic MRIs were reviewed by two blinded investigators, the three axes of the neoclitoris were measured and the volume was calculated using the ellipsoid formula. The distance between the neoclitoris and the neovagina was also measured. Sexual functioning was assessed using the Female Sexual Function Index (FSFI) and the operated Male to Female Sexual Function Index (oMtFSFI). Mean scores differences in FSFI, oMtFSFI were examined; associations with clitoral size, location, sexual functioning and demographical variables were investigated as well. The response rate was 55%, 11 MtFs operated with pubic neoclitoris technique (PNT) and 11 with neo-urethroclitoroplasty according to Petrović (NCP). The NCP group presented a neoclitoris mean volume of 1.04 (SD 0.39) cc vs 1.31 (SD 0.78) cc of the other group (p = 0.55). The mean distance between neoclitoris and neovagina was 4.20 (SD 0.57) cm in the PNT group and 2.55 (SD 0.45) in the NCP group (p < 0.001). Patients who had undergone NCP achieved a higher FSFI and oMtFSFI mean Total Score than those operated with the previous technique (FSFI 25.81 SD 3.02 vs 18.62 SD 9.92 p = 0.08; oMtFSFI 37.63 SD 8.28 vs 43.36 SD 13.02 p = 0.23). According to pelvic MRI measurements, this study suggests a correlation between neoclitoral location and oMtF sexual satisfaction.

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Fig. 1: Pubic neoclitoris technique.
Fig. 2: Neourethroclitoroplasty according to Petrović.

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Data availability

The data that support the findings of this study are available from the corresponding author, [FV], upon reasonable request.

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Authors and Affiliations

  1. Urologic Clinic, Department of Medical, Surgical and Health Science, University of Trieste, Trieste, Italy

    Francesca Vedovo, Nicola Pavan, Gaetano Chiapparrone, Luca Ongaro, Giovanni Liguori & Carlo Trombetta

  2. Department of Radiology, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy

    Michele Bertolotto & Francesca Currò

  3. Institute for Maternal and Child Health—IRCCS “BurloGarofolo”, Trieste, Italy

    Manuela Giangreco & Fabio Barbone

  4. University of Udine, Medical Area, Udine, Italy

    Fabio Barbone

Authors
  1. Francesca Vedovo
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  2. Nicola Pavan
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  3. Michele Bertolotto
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  4. Manuela Giangreco
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  5. Gaetano Chiapparrone
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  6. Luca Ongaro
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  7. Francesca Currò
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  8. Giovanni Liguori
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  9. Fabio Barbone
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  10. Carlo Trombetta
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Contributions

Conceptualization: FV, MB, and CT; Data curation: FV, MB, GC, FC, and LO; Methodology: FV and CT; Software: GC, GL, and LO; Investigation: FC and GL; Formal analysis: MG and FB; Writing – Original Draft: FV, NP, MB, and MG; Writing—Review & Editing: NP and CT; Supervision: NP, MB, FB, and CT.

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Correspondence to Francesca Vedovo.

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Vedovo, F., Pavan, N., Bertolotto, M. et al. Neoclitoral location may affect sexual function in transgender women: a preliminary pelvic MRI study. Int J Impot Res 36, 526–530 (2024). https://doi.org/10.1038/s41443-023-00716-2

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