Anat Cell Biol.  2024 Jun;57(2):183-193. 10.5115/acb.24.027.

Anatomy of the clitoris: the corona of the glans clitoris, clitoral coronal papillae, and the coronopreputial frenulum

• Zdilla MJ

• KMID: 2556562
• DOI: http://doi.org/10.5115/acb.24.027

Abstract

The corona of the glans clitoris is a clinically important yet poorly understood anatomical structure. There has been longstanding confusion regarding the prevalence of the corona of the glans clitoris and, moreover, its very existence. Therefore, this anatomical study assesses the prevalence of the corona of the glans clitoris and the gross anatomy of the proximal glans clitoris. Anatomy was assessed in 104 female donor bodies ranging in age from 50 to 102 years with an average age-at-death of 78.1±10.9 years (mean±SD). All clitorises (100%; 104:104 dorsums and 100%; 208:208 sides) were found to have a well-defined clitoral corona. Three of 104 (2.9%) coronas possessed grossly visible, outward-projecting, bluntly rounded papillae. Some donors possessed a coronopreputial frenulum. Clitoropreputial adhesions were common and associated with clitoral pearls. Clitoral pearls were identified in 37.8% (14:37) of unembalmed donors and observed to create clitoral craters, structural deformations in the surface of the corona and glans. The results of this study suggest that the corona of the glans clitoris is a ubiquitous anatomical structure. The clitoral coronal papillae and coronopreputial frenulum are novel, previously undescribed, anatomical structures. This study identifies that the corona of the glans clitoris is prone to pathological processes such as clitoral pearl formation and clitoral deformation. In addition to novel anatomical findings, the results of this study call attention to the need for life-long clitoral examinations. Furthermore, the corona of the glans clitoris should be regularly included in anatomical texts and accurately depicted in anatomical illustrations.

Keyword

Anatomy; Clitoris; Vulva; Gynecology; Women’s health

Figure

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  Fig. 1 Anatomy of the glans clitoris featuring the corona of the glans clitoris and the coronal sulcus. (A, B) Anterior and left dorsolateral views of the glans clitoris in a 90-year-old embalmed white female donor with a bisected prepuce. (C, D) Dorsal and right lateral view the glans clitoris in a 64-year-old recently deceased, unembalmed, white female donor with prepuce intact and retracted. C, corona; CS, coronal sulcus; F, frenulum/frenulae; G, glans clitoris; GPS, glandopreputial sulcus/balanopreputial sulcus; Lmaj, labium majus; Lmin, labium minus; P, prepuce; P*, prepuce bisected.

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  Fig. 2 Coronopreputial frenulae (white arrowheads) joining the corona of the glans clitoris (black stars) to the prepuce of the clitoris from dorsal and left lateral views. The superimposed black boxes correspond to adjacent magnified views. (A) Coronopreputial frenulum in a 95-year-old unembalmed white female donor. (B) Coronopreputial frenulum in a 71-year-old embalmed white female donor.

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  Fig. 3 Stereomicroscopy of three clitorises with denticulate papillae located along the periphery of each corona. Each row of images represents a series of increasing magnification from left to right. Superimposed black boxes correspond to adjacent magnified views. (A) Corona of an 86-year-old white female with marked papillae, arranged in-line, creating a fimbriated ridge along the distal aspect of the corona. Papillae are bluntly rounded and are separated from one another at their bases. Some papillae have pale-colored tips and independent bases, representing “pearly” papillae. (B) Corona of an 81-year-old white female which possesses papillae that are arranged in several rows, projecting distally from the corona. (C) Corona of a 75-year-old black female donor with bluntly rounded papillae with independent bases. Most papillae are bluntly rounded; however, the papilla in the upper right corner is conical.

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  Fig. 4 Preputial retraction and subsequent lysis of adhesions reveals occult clitoral pearls. Preputial retraction is resisted by adhesion between the glans clitoris and prepuce, thus indicating the distal-most aspect of the adherent tissues which remain upon the glans after lysis and mark the clitoropreputial delamination margin (black arrowheads). (A) Left and right lateral views of retraction and delamination of the prepuce from the glans in a 76-year-old unembalmed white female donor body revealing underlying clitoral pearls. (B) Right lateral view of retraction and delamination of the prepuce from the glans in a 72-year-old unembalmed black female donor body revealing underlying clitoral pearls.

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  Fig. 5 Clitoral pearls located proximal to clitoropreputial adhesions (CPAs) (black arrowheads). (A) Left-sided dorsolateral view of clitoral pearls located along the corona of a 92-year-old embalmed white female donor. (B) Clitoral pearls in a 75-year-old unembalmed white female donor are shown alongside a crenulated CPA remnant that mirrors the contour of the pearls. (C) Clitoral pearls are seen along the corona of the clitoris and proximal to a wavy-contoured remnant of a CPA in a 76-year-old embalmed white female donor. (D) Clitoral pearls are clustered proximal to a far-distally-located CPA remnant in a 73-year-old embalmed white female donor.

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  Fig. 6 Macrophotography and stereomicroscopy (images with orange hue) detailing clitoral pearls, and clitoral craters (white arrowheads), proximal to clitoropreputial adhesions (CPAs) (black arrowheads) in three example clitorises. Each row of images represents a series of increasing magnification from left to right. Superimposed black boxes correspond to adjacent magnified views. (A) A clitoral crater, formed by a clitoral pearl, is seen at the distal margin of the corona (stars) and proximal to a CPA in the clitoris of a 92-year-old white female donor body. A fringe of remnant preputial tissues remains adherent to the glans (yellow arrowheads). (B) Small clitoral pearls located proximal to a CPA are seen leaving clitoral craters post-removal in the clitoris of a 71-year-old white female donor body. Scale bars are found in stereomicroscopic images to illustrate the relatively small size of the clitoral pearls and the remnant craters. (C) Clitoral craters and remnants of the tissues covering the cavities which occupied clitoral pearls (blue arrowheads) are seen interspersed with numerous, relatively smaller, clitoral pearls in the clitoris of a 76-year-old white female donor body. Preputial craters (green arrowheads) are also seen on the face of the prepuce immediately opposing the clitoral crater.

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