Читать книгу Ridley's The Vulva - Группа авторов - Страница 56

The vulva consists of seven main parts: the mons pubis, the labia majora and minora, the vestibule of the vagina, the hymen, the clitoris, and the external urethral orifice (Figure 2.1). All of these structures may vary in size and symmetry, but this is a subject that has been rather neglected. In a study of 59 textbooks, very little was included about this topic [1]. Patients often worry about normal variants and the quest for the ‘perfect’ vulva. Indeed, in a study of 33 women seeking labial reduction, all had labia minora within normal limits [2]. This incorrect perception was confirmed in another study of younger adolescent girls presenting for consideration of genital surgery. Again, none had documented abnormality [3]. Patients will also perceive an abnormality if the labia minora are visible, even though they are of normal size [4]. There has been more interest recently in the normal variation in appearance of the vulva in both popular culture and the scientific literature. The artist Jamie McCartney took plaster casts of 400 vulvas to create a sculpture which illustrates the wide range of appearance (www.greatwallofvagina.co.uk), and this has been used as both an artistic and educational resource.

Several studies have addressed the normal vulval appearance in adults [5,6,7], prepubertal girls [8,9], and adolescents [10]. These studies include women of different ethnicities but the measurements are similar, and average measurements of the vulval structures in adults are shown in Table 2.1. It has been shown that genital dimensions have no effect on sexual function [11].

Figure 2.1 Anatomy of the normal vulva.