Myth? Coital Incontinence? Skene Duct

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Transcript Myth? Coital Incontinence? Skene Duct

Female Ejaculation:
Myth? Coital Incontinence?
Skene Duct Secretion?
Pooling of Vaginal fluid?
Bernie Brenner
Pelvic Floor Clinic Auckland
• Anatomy
• Non Urinary Origin
– Female Ejaculate
• G Spot
• Ejaculate Fluid
– Pooled Vaginal Fluid
• Urinary Origin
– Stress Urinary Incontinence
– Detrussor Contraction
The Female Ejaculate
Anatomical Considerations
– Skene’s Gland or ducts analagous to the male
Non Urinary Origin - History
Grafenberg in ‘50 postulates the existence
of an ejaculate of non urine fluid during
orgasm .
Addiego ’81 finds a higher level of prostatic
acid phospahtase and also coins the Term
“G Spot”
Grafenberg E. The role of the urethra in female orgasm. Int J Sexology 1950;3:145-8
Addiego F, et al Female ejaculation: a case study. J Sex Res 1981;17:1-13
The G Spot - ? Connection with
Female ejaculation
• G spot refers to a small highly sensitive
area on the anterior vaginal wall near
• G spot and ejaculation considered
together because stimulation of spot leads
to a more intense orgasm with resultant
Goldberg DC et al. The G spot and female ejaculation: a review of initial hypotheses. J Sex Marital Ther
G Spot Review
Hines writes on the G spot
Reviews literature from several perspectives
concludes “ the G spot will remain a sort of
gynae UFO: much searched for, much
discussed, but unverified by objective
[2001 Am J O&G]
Nevertheless with a ruler, a calculator and a colposcope:
Female Ejaculate
Biochemical considerations
Prostate–specific antigen present
Prostate-specific acid phosphatase
Zaviacic M, Ablin RJ. The female prostate and prostate-specific antigen. Immunohistochemical localization, implications for this prostate marker
in women, and reasons for using the term “prostate” in the human female. Histol Histopathol 2000;15: 131-42
Pooling of vaginal fluid
Coital Incontinence Urinary
• Mechanisms of urine loss during
sexual activity
– Multi-factorial
but common 23 to 34%
– Leakage with deep penetration and
abdominal pressure 77%
– Leakage with orgasm 74%
– Leakage with clitoral stimulation 50%
Vierhout ME Mechanisms of urine loss during sexual activity Eur J Obstet Gynecol Reprod
Biol. 1993 Nov;52(1):45-7
Korda and Hilton studies
Detrussor Contraction
• Skene Glands ejaculate
• Pooling of fluid and levator contraction
with orgasm
• Coital / Stress urinary incontinence /
Detrussor Contraction
And the G spot?
Probably most easily found at the end of the
word “shoppinG”