2.-4. parmak uzunlukları oranı ile ultrasonografik üretrovajinal alan ölçümlerinin korelasyonu

Öz

Amaç: İkinci- dördüncü parmak uzunlukları oranı (2D:4D), fetal yaşamda androjen maruziyetinin bir göstergesi olarak kullanılır. Ürogenital sistem ve parmak uzunluğunun farklılaşmasının Homeobox genleri (HoxA ve HoxD) tarafından kontrol edildiği bilinmektedir. Bu nedenle parmakların antropometrik özellikleri ile bağlantılı faktörlerin genetik ve hormonal temele bağlı olarak ürogenital anatomi ile ilişkili olması beklenir. Bu çalışmanın amacı 2D:4D oranı ile üretrovajinal aralık ölçümleri arasındaki korelasyonun değerlendirilmesidir. Materyal ve yöntem: Bu prospektif kohort çalışmada üreme dönemindeki otuz bir kadının sonuçları değerlendirilmiştir. Ellerin dijital antropometrik ölçümler ve üretrovajinal aralığın ultrasonografik ölçümleri yapılmış, bu parametreler arasındaki korelasyon değerlendirildi. Bulgular: Sağ ve sol el 2D:4D oranı ile üretrovajinal boşluk uzunluğu arasında anlamlı negatif korelasyon saptandı (sırasıyla p=0,007 ve p=0,003). Proksimal, orta ve distal segmentteki üretrovajinal boşluğun kalınlığı da her iki el için 2D:4D oranı ile negatif korelasyon gösterdi. Sonuç: Mevcut çalışmanın bulguları 2D:4D oranı ile üretrovajinal boşluk ölçümleri arasında bir ilişki olduğunu göstermiştir. Bu verilerden elde edilen içgörüler, 2D:4D ve kadın genital anatomisi arasındaki ilişki hakkında gelecekteki araştırmalar için bir temel teşkil edecektir. Bu çalışma ayrıca UVS' nin anatomik özelliklerine ilişkin ek kanıtlar sağlamıştır.

Anahtar Kelimeler

• parmak oranı
• kadın
• genital anatomi
• üretrovajinal boşluk

Correlation between 2nd to 4th digit ratios and ultrasonographic measurements of urethrovaginal spa

Öz

Aim: Second to fourth digit (2D:4D) ratio is used as an indicator of androgen exposure in fetal life. It is known that the differentiation of urogenital tract and finger length are both controlled by Homeobox genes (HoxA and HoxD). Therefore, factors that are connected with anthropometric characteristics of fingers are expected to be in relation with urogenital anatomy, depending on genetic and hormonal basis. Aim of the study is to evaluate the correlation between 2D:4D ratio and urethrovaginal space measurements. Materials and methods: In this prospective cohort study, digital anthropometric measurements of hands and ultrasonographic measurements of urethrovaginal space were evaluated and the correlation between these parameters were assessed in a sample of women in reproductive period. Results: A significant negative correlation was detected between both right and left hand 2D: 4D ratio and length of urethrovaginal space (p=0.007 and p=0.003, respectively). The thickness of urethrovaginal space at proximal, middle and distal segment was also correlated negatively with 2D:4D ratio for both hands. Conclusion: The findings of the current study have shown a correlation between 2D: 4D ratio and urethrovaginal space measurements. The insights gained from these data will serve as a base for future research about the relationship between 2D:4D and female genital anatomy. The present study has also provided additional evidence with respect to anatomical features of UVS.

Anahtar Kelimeler

• digit ratio
• female
• genital anatomy
• urethrovaginal space

Kaynakça

1. 1. Krantz K. E. Innervation of the human vulva and vagina, a microscopic study. Obstet Gynecol 1958; 12 (4): 382–96.
2. 2. Battaglia C, Nappi R., Mancini F., Del Forno S., Battaglia B., et al. 3-D volumetric and vascular analysis of the urethrovaginal space in young women with or without vaginal orgasm. J Sex Med 2010; 7(4): 1445–53. https://doi.org/ 10.1111/j.1743-6109.2009.01650.x.
3. 3. O’Connel H., DeLancey, J. Clitoral anatomy in nulliparous, healthy, premenopausal volunteers using unenhanced magnetic resonance imaging. J Urol 2005; 173(6):2060–3. https://doi.org/ 10.1097/01.ju.0000158446.21396.c0
4. 4. Maravilla K., Yang C., Magnetic resonance imaging and the female sexual response: Overview of techniques, results, and future directions, J Sex Med 2008; 5 (7):1559–71. https://doi.org/ 10.1111/j.1743-6109.2008.00839.x.
5. 5. Garcia S., Talakoub L., Maitland S., Dennis A., Goldstein I., Munarriz R. Genital duplex Doppler ultrasonography before and after sexual stimulation in women with sexual dysfunction: Gray scale, volumetric, and hemodynamic findings. Fertil Steril 2005; 83(4):995–9. https://doi.org/ 10.1016/j.fertnstert.2004.09.032.
6. 6. Battaglia C., Nappi R., Mancini F., Alvisi S., Del Forno S., Battaglia B., et al. PCOS and urethrovaginal space: 3-D volumetric and vascular analysis. J Sex Med 2010; 7(8):2755–64. https://doi.org/10.1111/j.1743-6109.2009.01651.x.
7. 7. Gravina G., Brandetti F., Martini P., Carosa E., Di Stasi S., Morano S, et al. Measurement of the thickness of the urethrovaginal space in women with or without vaginal orgasm. J Sex Med 2008; 5(3):610–8. https://doi.org/10.1111/j.1743-6109.2007.00739.x.
8. 8. Zaviačič M., Jakubovská V., Belošovič M., Breza J. Ultrastructure of the normal adult human female prostate gland (Skene’s gland). J Anat Embryol 2000;201(1): 51–61. https://doi.org/10.1007/pl00022920.

9. 9. Zaviacic M., Ablin R. The female prostate and prostate-specific antigen. lmmunohistochemical localization, implications of this prostate marker in women and reasons for using the term" prostate" in the human female. Histol histopathol 2000; 15(1):131–42. https://doi.org/10.14670/HH-15.131.
10. 10. Huffman J. The detailed anatomy of the paraurethral ducts in the adult human female, Am J Obstet Gynecol 1948; 55(1):86–101, https://doi.org/10.1016/0002-9378(48)90157–4.
11. 11. Jeevanandam S., Muthu P. 2D:4D Ratio and its Implications in Medicine. J Clin Diagn Res 2016; 10(12):1-3. https://doi.org/10.7860/JCDR/2016/21952.9000.
12. 12. Lutchmaya S., Baron-Cohen S., Raggatt P., Knickmeyer R., Manning J. 2nd to 4th digit ratios, fetal testosterone and estradiol, Early Hum Dev 2004; 77(1):22–28. https://doi.org/10.1016/j.earlhumdev.2003.12.002.
13. 13. C. Zhang, J. Dang, L. Pei, M. Guo, H. Zhu, L. Qu, et al. Relationship of 2D: 4D finger ratio with androgen receptor CAG and GGN repeat polymorphism. Am J Hum Biol 2013; 25 (1):101–06. https://doi.org/10.1002/ajhb.22347.
14. 14. Davarci M., Gökçe A., Yalçinkaya F., Kaya Y., Turhan E., Tutanç M., et al. A new anthropometric measurement of penile length and its relation to second and fourth digital lengths. Turk J Med Sci 2012; 42 (3):539–44. https://doi.org/10.3906/sag-1103-32.
15. 15. I. Choi, K. Kim, H. Jung, S. Yoon, S. Kim, T. Kim. Second to fourth digit ratio: a predictor of adult penile length. Asian J Androl 2011; 13(5):710–714. https://doi.org/10.1038/aja.2011.75.
16. 16. Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group, Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril 2004; 81(1):19–25. https://doi.org/10.1016/j.fertnstert.2003.10.004
17. 17. R. Burriss, A. Little, E. Nelson, 2D:4D and sexually dimorphic facial characteristics. Arch Sex Behav 2007; 36(3):377–84. https://doi.org/10.1007/s10508-006-9136-1.
18. 18. Manning J., Stewart A., Bundred P., Trivers R. Sex and ethnic differences in 2nd to 4th digit ratio of children. Early Hum Dev 2004; 80(2):61–8. https://doi.org/10.1016/j.earlhumdev.2004.06.004.
19. 19. Tabachnik M., Sheiner E., Wainstock T. The association between second to fourth digit ratio, reproductive and general health among women: findings from an Israeli pregnancy cohort. Sci Rep 2020; 10(1):6341. https://doi.org/ 10.1038/s41598-020-62599-3.
20. 20. Muller D., Baglietto L., Manning J., McLean C., Hopper J., English D., et al. Second to fourth digit ratio (2D: 4D), breast cancer risk factors, and breast cancer risk: a prospective cohort study. Br J Cancer 2012; 107(9):1631–6. https://doi.org/10.1038/bjc.2012.418.
21. 21. Brabin L., Roberts S., Farzaneh F., Fairbrother E., Kitchener H. The second to fourth digit ratio (2D:4D) in women with and without human papillomavirus and cervical dysplasia. Am. J Hum Biol 2008; 20(3):337–341. https://doi.org/10.1002/ajhb.20731.
22. 22. Wernert N., Albrecht M., Sesterhenn I., Goebbels R., Bonkhoff H., Seitz G., et al. The “female prostate”: Location, morphology, immunohistochemical characteristics and significance. Eur Urol 1992; 22(1):64–9. https://doi.org/10.1159/000474724.
23. 23. F. Wimpissinger, K. Stifter, W. Grin, W. Stackl, The female prostate revisited: Perineal ultrasounds and biochemical studies of female ejaculate. J Sex Med 2007; 4(5):1388–93. https://doi.org/10.1111/j.1743-6109.2007.00542.x.
24. 24. Komisaruk B., Wise N., Frangos E., Liu W., Allen K., Brody S.. Women's clitoris, vagina, and cervix mapped on the sensory cortex: fMRI evidence. J Sex Med 2011; 8(10):2822–30. https://doi.org/10.1111/j.1743-6109.2011.02388.x.
25. 25. O’Connell H, J. Hutson, C. Anderson, R. Plenter, Anatomical relationship between urethra and clitoris. J Urol 1998; 159(6):1892–7. https://doi.org/10.1016/s0022-5347(01)63188-4.