New Insights from One Case of Female Ejaculation

Rubio‐Casillas, Alberto; Jannini, Emmanuele A.

doi:10.1111/j.1743-6109.2011.02472.x

Cited by 39 publications

(63 citation statements)

References 11 publications

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“…FE is an orgasmic expulsion of a smaller quantity of whitish fluid produced by the female prostate . Opinions regarding the quantity of expelled fluid vary from 1 mL to 30–50 mL . Following the work of E. Gräfenberg regarding the role of the urethra at sexual arousal , Addiego et al.…”

Section: Resultsmentioning

confidence: 99%

Female Ejaculation Orgasm vs. Coital Incontinence: A Systematic Review

Pastor

2013

The Journal of Sexual Medicine

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Introduction Women may expel various kinds of fluids during sexual arousal and at orgasm. Their origins, quantity, compositions, and expulsion mechanisms depend on anatomical and pathophysiological dispositions and the degree of sexual arousal. These are natural sexual responses but may also represent symptoms of urinary incontinence. Aim The study aims to clarify the etiology of fluid leakage at orgasm, distinguish between associated physiological sexual responses, and differentiate these phenomena from symptoms of illness. Methods A systematic literature review was performed. EMBASE (OvidSP) and Web of Science databases were searched for the articles on various phenomena of fluid expulsions in women during sexual arousal and at orgasm. Main Outcome Measures Articles included focused on female ejaculation and its variations, coital incontinence (CI), and vaginal lubrication. Results Female ejaculation orgasm manifests as either a female ejaculation (FE) of a smaller quantity of whitish secretions from the female prostate or a squirting of a larger amount of diluted and changed urine. Both phenomena may occur simultaneously. The prevalence of FE is 10–54%. CI is divided into penetration and orgasmic forms. The prevalence of CI is 0.2–66%. Penetration incontinence occurs more frequently and is usually caused by stress urinary incontinence (SUI). Urodynamic diagnoses of detrusor overactivity (DOA) and SUI are observed in orgasmic incontinence. Conclusions Fluid expulsions are not typically a part of female orgasm. FE and squirting are two different physiological components of female sexuality. FE was objectively evidenced only in tens of cases but its reported high prevalence is based mostly on subjective questionnaire research. Pathophysiology of squirting is rarely documented. CI is a pathological sign caused by urethral disorder, DOA, or a combination of both, and requires treatment. An in-depth appreciation of these similar but pathophysiologically distinct phenomena is essential for distinguishing normal, physiological sexual responses from signs of illness.

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Section: Resultsmentioning

confidence: 99%

Female Ejaculation Orgasm vs. Coital Incontinence: A Systematic Review

Pastor

2013

The Journal of Sexual Medicine

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“…The term female ejaculation is often a shared paradigm that includes any fluid expelled during sexual activities. 51 Ejaculation orgasm, defined as a physiological response that occurs at the height of sexual arousal, manifests as either a 'real' female ejaculation (scanty, thick and whitish fluid from the Skene glands) or a squirting or gushing expulsion of a larger amount of diluted and changed urine. 48 Female ejaculation is thought to be an uncommon, physiological phenomenon that occurs only in some women, but can sometimes resemble orgasmic urinary incontinence.…”

Section: Coital Incontinencementioning

confidence: 99%

Stress urinary incontinence and LUTS in women—effects on sexual function

2014

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The sexual impact of urinary incontinence in women depends on a host of parameters, including physical, psychological, social and cultural dimensions. Evaluation of the effects of stress urinary incontinence (SUI) and lower urinary tract symptoms on sexual function is often biased by their common association with other pelvic floor disorders, such as pelvic organ prolapse, which also affect sexual satisfaction. Indeed, these complexities are reflected in the literature, which shows considerable disparity in sexual functional characteristics in women with incontinence both before and after treatment. This discordance is further emphasized by heterogeneity in study design, quality and analysis. Here, we describe the nature of sexual dysfunction in women with incontinence, including coital incontinence. The various treatments for SUI, which include transvaginal tape surgeries, can also affect sexual function, positively or negatively. Coital incontinence seems to be a good predictor of an improvement in postoperative sexual parameters: its cure, achieved by >90% of women, to a large extent explains the sexual benefits reported in several studies. By contrast, deterioration in sexual function is sometimes reported after surgery, with de novo or worsened dyspareunia being the most common cause. The literature does not contain any convincing arguments for one treatment or another on the basis of sexual functional outcome.

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“…We concluded that the stable, or even improved, postoperative sexual function was, more likely than not, related to the elimination of “coital urinary incontinence” that many women with stress incontinence are, to varying degrees, distressed by during sexual activity 35, 36, 37. We emphasize the importance of distinguishing “coital urinary incontinence” from “female ejaculation and vaginal orgasm during sexual activity” as two distinctly different entities.…”

Section: Discussionmentioning

confidence: 85%

A Meta-Analysis Detailing Overall Sexual Function and Orgasmic Function in Women Undergoing Midurethral Sling Surgery for Stress Incontinence

Szell

Komisaruk

Goldstein³

et al. 2017

Sexual Medicine

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IntroductionMore than 200,000 midurethral slings are placed yearly for stress urinary incontinence. Approximately 14% to 20% of women experience worsening sexual function overall after these procedures. We postulated that sling placement injures neural pathways regulating “female prostate” tissue within the anterior vaginal wall.AimTo perform a meta-analysis for overall sexual function and orgasm using validated questionnaires for transvaginal tape, transobturator tape, and their variants.MethodsEffect sizes of preoperative and postoperative questionnaire scores for overall sexual function and orgasm were calculated. Random-effects models were selected for meta-analyses. Statistical analysis involved determination of the ratio of total heterogeneity to total variability.Main Outcome MeasuresDifferences of overall sexual and orgasm functions were calculated by subtracting postoperative sling scores from preoperative sling scores. Forest plots of effect sizes were performed.ResultsSixty-seven percent of midurethral sling procedures analyzed showed no change or improvement in overall sexual function postoperatively, whereas 33% of studies analyzed for orgasm function showed improvement after the procedure. For transvaginal tape, mean total sexual function and orgasm postoperative scores were significantly higher than preoperative scores. For transobturator tape, mean total postoperative score was significantly higher than the preoperative score; however, the mean orgasm postoperative score was not significantly higher than the preoperative score, possibly because of variability in transobturator tape data.ConclusionThere is a discrepancy between postoperative sexual satisfaction and orgasmic function after midurethral sling surgery. Although overall sexual function remained the same or improved for most women, orgasmic function in only one third of cases improved overall, with most women experiencing no change or deterioration in orgasmic function. Dissection for, and placement of, the midurethral sling can compromise the neural integrity of the anterior vaginal wall, thereby detrimentally affecting the periurethral prostate tissue that is essential to the orgasmic response. We propose that this surgical procedure can compromise orgasmic function in some women.Szell N, Komisaruk B, Goldstein SW, et al. A Meta-Analysis Detailing Overall Sexual Function and Orgasmic Function in Women Undergoing Midurethral Sling Surgery for Stress Incontinence. Sex Med 2017;5:e84–e93.

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New Insights from One Case of Female Ejaculation

Cited by 39 publications

References 11 publications

Female Ejaculation Orgasm vs. Coital Incontinence: A Systematic Review

Female Ejaculation Orgasm vs. Coital Incontinence: A Systematic Review

Stress urinary incontinence and LUTS in women—effects on sexual function

A Meta-Analysis Detailing Overall Sexual Function and Orgasmic Function in Women Undergoing Midurethral Sling Surgery for Stress Incontinence

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