Correlation between the thickness of the Urethrovaginal Space and Female Sexual Function Index
IUGA Academy. YASSA M. Jun 30, 2018; 212819
Topic: Sexual Dysfunction

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Correlation between the thickness of the urethrovaginal space and female sexual function index

Yassa, M1; Yildirim Eser, G1; Sargin, MA1; Yirmibes, C1; Uruc, E1; Tug, N1


Introduction: The presence of the G-spot and the anatomy of orgasmic areas remain controversial. The measurement of the thickness of the urethrovaginal space was recently found to be differed between women with or without vaginal orgasm. The external validation of these findings was needed.

Objective: The purpose of this preliminary analysis was to assess the correlation between urethrovaginal space measurements and a validated questionnaire for sexual function.

Methods: Female Sexual Function Index (FSFI) and the ultrasound evaluation obtained by transperineal approach were performed during the mid-follicular phase of their menstrual cycle. Women with pelvic organ prolapsed, clinical urinary and fecal incontinence and without any sexual intercourse at previous four weeks were excluded. The borders of urethrovaginal space was defined as a line drawn between the border of the smooth muscle and mucosa-submucosa layer of the urethral wall and the border of the vaginal wall and its lumen.1 Measurements were taken at the 10th (proximal segment), 50th (middle segment), and 90th percentile (distal segment) of the urethra. The correlation between the sonographic measures and FSFI and its subdomains; desire, arousal, lubrication, orgasm, satisfaction and pain. Interobserver and intraobserver reliability at 3rd day were also assessed.

Results: A total of 13 participants were included. Total FSFI scores of the participants had a mean of 22.94 with 1.29 of standart error. Of those, four participants had FSFI scores lower than 26.5. Mean age and body mass index were 30.8±7.4 and 27.6±5.1, respectively. Demographic features did not differ between women with or without sexual dysfunction. Thickness of the urethrovaginal space were 14.1±0.36 mm, 11.5±0.37 mm and 10.6±0.38 mm for proximal, middle and distal segments, respectively. Proximal segment of urethrovaginal space exhibited moderate to strong correlation with orgasm (r=0.632, p= 0.037) and lubrication (r=0.672, p=0.024) (Table 1). Interobserver agreement between the two evaluators and intraobserver agreement repeated at 3rd day were excellent (r = 0.992, r=0992; P < 0.001, respectively).

Conclusions: A moderate to strong positive correlation was found between orgasm scores and proximal urethrovaginal space thickness in this preliminary study. The vascularity of the urethrovaginal space, the effect of the partner and the hormonal pattern will be assessed in a further study in a larger sample size.


1: Gravina GL, Brandetti F, Martini p et al. Measurement of the thickness of the urethrovaginal space in women with or without vaginal orgasm. The journal of sexual medicine, 2008, 5.3: 610-618.

Table 1. Correlation between thickness of the urethrovaginal space and Female Sexual Function Index subgroups








Total FSFI score

Distal segment








Middle segment








Proximal segment
















Pearson Partial Correlation, control variables: age and BMI

ap = 0.024, bp = 0.037, cp = 0.04


Work supported by industry: no.

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