Login to Access Video or Poster Abstract: MP91-19
Sources of Funding: None

Introduction

Clinical trials have shown that biological women with anorgasmia possess a smaller clitoral glans and clitoral components farther from the vagina lumen than women with normal orgasmic function. The aim of this study is to evaluate neoclitoris size and location with regard to sexual function in patients undergoing male to female (MtF) gender reassignment surgery (GRS). For the evaluation of the normal post-operative changes and presence of complications, in our Centre, patients underwent MtF GRS performed a pelvic non-contrast MRI at 2-4 weeks after surgery.

Methods

From May to June 2015 we enrolled, during follow up visits, 40 Italian speaking transsexual women underwent MtF GRS and postoperative MRI in our Centre between 2004-2014. Sexual functioning was assessed using the Italian version of the Female Sexual Function Index (FSFI). MR Scans were acquired with a 1.5T superconductive equipment in sagittal and axial planes using a multichannel phased array coil for parallel imaging. TSE T2-weighed images were obtained with 3-4mm thick contiguous sections. The neovagina and the rectum were distended with gel or a vaginal tutor inserted._x000D_ Individual pelvic MRIs were reviewed by blinded investigators, the three axes of the neoclitoris were measured and the volume calculated using the ellipsoid formula. The distance between the neoclitoris and the neovagina was measured. Data included demographics, sexual history, previous surgery, partnership status, body mass index (BMI), past and current medical history, chronic medical treatments, education, job. _x000D_

Results

22 patients completed the study. The mean age was 34 years (SD 7.44). The majority were Caucasians (N=20, 91%) and in a relationship (N=13, 51%). At the MRI neoclitoris mean volume was 1.18 cc (SD 0.43), coronal area 6.80 cm2 (SD 2.4) and 5.33 cm2 (SD 1.34) in sagittal view, the mean distance between neoclitoris and neovagina was 3.38 cm (SD 0.5). There is a statistically significant correlation between the parameter that evaluates the distance between the neoclitoris and the neovagina and the FSFI total score (p < 0.0001). Neoclitoris size did not significantly correlate with FSFI total score (p=0.76).

Conclusions

This study showed that, even in patients undergoing GRS, neoclitoris localization could be considered a parameter for evaluating sexual function and that a reduction of the distance between neovagina and neoclitoris is associated with greater sexual satisfaction. Neoclitoris size seems not to affect MtF sexual function.

Funding

None