ArticleThe British journal of radiology2021
A first radiotherapy application of functional bulboclitoris anatomy, a novel female sexual organ-at-risk, and organ-sparing feasibility study.
Article in The British journal of radiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 15 citations in OpenAlex.
- Sexual function in chronic illness and cancer perspectives of the patient, partner, and healthcare provider; innovations; and updates: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).Sexual medicine reviews · 2026Review
- The "Undefined and Ignored Normal Tissue" Bulboclitoral Complex in Locally Advanced Cervical Cancer Treated with Definitive Radiochemotherapy: Is It Not the Organ at Risk?Medicina (Kaunas, Lithuania) · 2025Article
- A feasibility study of sexual organ-dose sparing volumetric modulated arc therapy in female low rectal cancer patients treated with three-dimensional conformal radiation therapy.Journal of applied clinical medical physics · 2025Article
- Defining and sparing sexual function-related organs at risk for rectal cancer radiotherapy.Acta oncologica (Stockholm, Sweden) · 2025Article
- Sex-Based Bias in Artificial Intelligence-Based Segmentation Models in Clinical Oncology.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2025Review
- Under-representation for Female Pelvis Cancers in Commercial Auto-segmentation Solutions and Open-source Imaging Datasets.Clinical oncology (Royal College of Radiologists (Great Britain)) · 2025Article
- Pleasurable and problematic receptive anal intercourse and diseases of the colon, rectum and anus.Nature reviews. Gastroenterology & hepatology · 2024Review
- Gender-Affirming Surgery and Cancer: Considerations for Radiation Oncologists for Pelvic Radiation in Transfeminine Patients.International journal of radiation oncology, biology, physics · 2023Review
- Female erectile tissues and sexual dysfunction after pelvic radiotherapy: A scoping review.CA: a cancer journal for clinicians · 2022Article
- Getting c-Literate: Bulboclitoris Functional Anatomy and Its Implications for Radiation Therapy.Practical radiation oncologyArticle
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe bulboclitoris (clitoris and vestibular bulbs) is the primary organ responsible for female sexual arousal and orgasm. Effects of radiotherapy on the bulboclitoris are unknown, as its structure/function has yet to be described in radiotherapy, and it overlaps only partially with the external genitalia structure. Our aim was to: describe bulboclitoris structure, function and delineation; compare volume of and dose delivered to the bulboclitoris
methodsOur expert team (anatomist, pelvic radiologist, radiation oncologist) reviewed bulboclitoris anatomy and developed contouring guidance for radiotherapy. 20 female patients with anal cancer treated with chemoradiation were analyzed. Sexual organs at risk (OARs) included the external genitalia and the bulboclitoris. Volumes, dice similarity coefficients (DSCs) and dose received using S-IMRT were compared. Plans were reoptimized using BCS-IMRT. Dose-volume histograms (DVHs) for PTVs and all OARs were compared for BCS-IMRT
resultsBulboclitoris structure, function and delineation are described herein. The bulboclitoris occupies 20cc (IQR:12-24), largely distinct from the external genitalia (DSC <0.05). BCS-IMRT was superior to S-IMRT in reducing the dose to the bulboclitoris, with the greatest reductions in V30 and V40, with no significant changes in dose to other OARs or PTV 1/V95.
conclusionThe bulboclitoris can be contoured on planning imaging, largely distinct from the external genitalia. Compared with S-IMRT, BCS-IMRT dramatically reduced dose to the bulboclitoris in anal cancer planning. BCS-IMRT might safely reduce sexual toxicity compared with standard approaches. ADVANCES IN KNOWLEDGE: The structure and function of the bulboclitoris, the critical primary organ responsible for female sexual arousal and orgasm, has yet to be described in the radiotherapy literature. Structure, function and delineation of the bulboclitoris are detailed, delineation and bulboclitoris-sparing IMRT were feasible, and sparing reduces the dose to the bulboclitoris nearly in half in female patients receiving IMRT for anal cancer, warranting further clinical study.
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