A small study from Poland has identified an anatomically distinct discrete G-spot within the vagina.

Anterior vaginal wall tissue was surgically removed, post-mortem, from eight women (age 37-68 years) who had died suddenly from acts of violence, suicide or drug overdose. Consent for each procedure was given by the Department of Forensic Medicine, Warsaw Medical University.

Excised specimens were subjected to microdissection and histological analysis which employed haematoxylin and eosin staining, and in two cases immunohistochemical staining as well.

In all eight women an anatomically distinct area was identified within the anterior vaginal wall. The area was located on average 4.5 cm proximal to the vagina’s vulval opening, and was on average 7 mm long. In seven of the women the area was located just to the left of the urethra.

Histologically, it consisted of a neurovascular tangle of grape-like venous structures, resembling an arteriovenous malformation, with feeder arterioles within a fibroadipose tissue bed. Nerve bundles and a large nerve ganglion were also identified.

These neurovascular features are not typical of the rest of the vaginal wall, and the presence of the large nerve ganglion had not been described in this area previously.

In the 1950s Ernst Gräfenberg stated that an erotic zone was located on the vaginal wall along the course of the urethra. Later, and apparently in his honour, this became known as the G-spot. Since then imaging techniques have been used to try and locate this area with precision, but with little success.

Two accompanying commentaries^1,2 in the same issue of the BJOG continue to debate whether the G-spot is fact or fantasy.

The demonstration of an anatomically discrete, neurovascular structure containing a nerve ganglion, located in the vicinity of the presumed G-spot is of interest not just in the discipline of sexual medicine but also to gynaecologists as well.

The investigators plan further studies but in the meantime they caution surgeons operating in this area that ‘precautions should be undertaken during an operation on the anterior vaginal wall to avoid ligating vasculature or injuring the G-spot complex.’

Dr Chris Barclay