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Physical examination is performed of the i skin overlying the right and left labia majora, right and left labia minora, and the sulcus between the 2 labia. ii the glans clitoris and prepuce. iii the urethral meatus. iv the vestibule between the Hart line and hymen, especially the vestibular glands at the 1. The benefits of magnification cannot be overstated because the anatomy becomes significantly clearer than with the naked eye alone. Open in a separate window. Abstract Introduction The glans clitoris is covered by a prepuce that normally moves over the glans surface and can be retracted beyond the corona. Of the remaining sexual function domains, the median scores were equally low for desire 2. Thus, the closed compartment between the prepuce and the clitoris can become irritated, erythematous, or infected. Low calculated free testosterone states are associated with hormonal-based contraceptives.

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Articles from Sexual Medicine are provided here courtesy of Elsevier. Another limitation is the isolated interpretation that the distressing sexual pain experienced by women in the study group was related to their clitoral adhesion. Published online Mar The exact cause of the clitoral adhesion in a specific patient usually cannot be identified. In some cases, in which the adhesions are recurrent, a more invasive solution could involve a dorsal slit surgical procedure. Main Outcome Measure Prevalence of severity of clitoral adhesions.

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Of the remaining sexual function domains, the median scores were equally low for desire 2. Thus, the closed compartment between the prepuce and the clitoris can become irritated, erythematous, or infected. In addition, blood tests are performed, including total testosterone, sex hormone binding globulin, estradiol, and calculated free testosterone. To determine the prevalence of clitoral adhesions in a sexual medicine practice and assess risk factors associated with clitoral adhesions. How can this discrepancy of a few women presenting to the sexual medicine clinic with complaints of sexual pain but scores on validated instruments showing substantial sexual pain be explained. The study population is biased and consists exclusively of women visiting a sexual medicine practice.

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Description: In summary, this study showed that vulvoscopy photographs of more than 1 in 5 women showed clitoral adhesions on a standardized method of optically magnified vulvoscopy examination with photography. The evolution and nature of female sexuality in relation to psychoanalytic theory. The study group had a median sensory score of 7 of 45 and a median overall intensity of pain score of 3 of 5, considered distressing pain. The criteria for inclusion of each vulvoscopy photograph were i good photographic focus of the glans clitoris and ii the presence of appropriate manual cephalad preputial retraction that allowed for full visualization of the glans corona. In our sexual medicine clinic, it is expected that patients with sexual health complaints will undergo a detailed genital physical examination including a detailed and systematic examination of the vulva using vulvoscopy magnification and photography. In particular, we wished to know answers to the following questions. Ideally a control comparison group also would be studied. Education and counseling should be provided concerning the pathophysiology of clitoral adhesions occurring secondary to conditions that adversely interfere with the health of the skin of the glans and the prepuce. Statement of authorship Category 1 a.
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