NEOCLITORIS SIZE AND LOCATION: CAN THEY AFFECT TRANSSEXUAL WOMEN SEXUAL FUNCTION? A PRELIMINARY PELVIC MRI STUDY

INTRODUCTION AND OBJECTIVES: 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. 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. RESULTS: 22 patients completed the study. The mean age was 34 years (SD 7.44). The majority were Caucasians (N¼20, 91%)