In search of a dynamic clitoral duplex sonography to measure the genital blood engorgement capability in females

Colpi GM, Mancini M, *Nappi RE, *Veneroni F
Andrology Service, San Paolo Hospital, University of Milano,
*Dept Ob/Gyn, IRCCS Policlinico San Matteo, University of Pavia (Italy)

2nd European Congress of Andrology Malmoe, 19-22 September 2002

Introduction & Objectives: Clitoral artery blood flow has been proposed as a good tool for clinical evaluation of the organic component of female sexual response. Our purpose was to assess genital vascular modifications caused by oral or local drugs in young normal women.

Materials & Methods: Fifteen young female volunteers (age 20-26 yrs) with normal BMI (19.4±1.4 kg/m2) and a regular menstrual cycle, sexually active without any complaint about sexual dysfunction (FSFI criteria), were studied during the early follicular phase. They were randomly assigned to Group A (7 pts.) and Group B (8 pts.). Group A underwent oral sildenafil 12.5 mg administration followed 60’ later by vibratory (70 Hz) stimuli application onto the mons pubis for 2 minutes. Group B underwent only a soft and rapid periclitoral application of Dinoprostone 0.5mg (“Prepidil” ^TM) gel (1 cm), which was removed after ten minutes. By means of a 7.5 MHz external probe, Duplex sonography of clitoral arterial circulation was performed on both sides, and Peak Systolic Velocity (PSV, cm/s) determined by the same investigator (M.M.), before and immediately after the assigned treatment. The mean three consecutive measurements was recorded for each side; the mean of the values obtained for each side was calculated for every volunteer. Data were analysed by two tail Student’s t-test.

Results: Clitoral PSV resulted 11.2±2.0 cm/s before and 15.5±4.3 cm/s after stimulus (p=0.033) in Group A, and 13.7±1.8 cm/s before and 18.2±6.1 cm/s (p=0.065) in Group B, respectively.

Conclusions: PSV of clitoral arteries is easy to measure. Adequate stimuli can significantly increase PSV, representing a new method to evaluate blood engorgement capability. Assessing this capability might be useful in determining the vascular component of female sexual dysfunctions, i.e. in post-menopausal women in which a reduced capability of vasocongestion has been suggested. Our team is trying to set a dynamic test able to investigate the genital blood engorgement capability of a woman. A dynamic test, simple and reliable, sufficiently respectful of female intimacy and without psychic influences would be indeed desirable in clinical practice.