Is the Female G-Spot Truly a Distinct Anatomic Entity? Amichai Kilchevsky, MD,* † Yoram Vardi, MD,* Lior Lowenstein, MD,* and Ilan Gruenwald, MD* *Neurourolgy Unit, Rambam Healthcare Campus, Haifa, Israel; † Department of Urology, Yale-New Haven Hospital, New Haven, CT, USA DOI: 10.1111/j.1743-6109.2011.02623.x ABSTRACT Introduction. The existence of an anatomically distinct female G-spot is controversial. Reports in the public media would lead one to believe the G-spot is a well-characterized entity capable of providing extreme sexual stimulation, yet this is far from the truth. Aim. The aim of this article was to provide an overview of the evidence both supporting and refuting the existence of an anatomically distinct female G-spot. Methods. PubMed search for articles published between 1950 and 2011 using key words “G-spot,” “Grafenberg spot,” “vaginal innervation,” “female orgasm,” “female erogenous zone,” and “female ejaculation.” Clinical trials, meeting abstracts, case reports, and review articles that were written in English and published in a peer-reviewed journal were selected for analysis. Main Outcome Measure. The main outcome measure of this article was to assess any valid objective data in the literature that scientifically evaluates the existence of an anatomically distinct G-spot. Results. The literature cites dozens of trials that have attempted to confirm the existence of a G-spot using surveys, pathologic specimens, various imaging modalities, and biochemical markers. The surveys found that a majority of women believe a G-spot actually exists, although not all of the women who believed in it were able to locate it. Attempts to characterize vaginal innervation have shown some differences in nerve distribution across the vagina, although the findings have not proven to be universally reproducible. Furthermore, radiographic studies have been unable to demonstrate a unique entity, other than the clitoris, whose direct stimulation leads to vaginal orgasm. Conclusions. Objective measures have failed to provide strong and consistent evidence for the existence of an anatomical site that could be related to the famed G-spot. However, reliable reports and anecdotal testimonials of the existence of a highly sensitive area in the distal anterior vaginal wall raise the question of whether enough investigative modalities have been implemented in the search of the G-spot. Kilchevsky A, Vardi Y, Lowenstein L, and Gruenwald I. Is the female G-spot truly a distinct anatomic entity? J Sex Med **;**:**–**. Key Words. G-Spot; Grafenberg Spot; Female Ejaculation Introduction D uring the first half of the 20th century, the consensus in the Western world was that the vagina had primarily a functional role in the process of reproduction and was, only secondarily, related to sexual pleasure. This notion is supported by early studies demonstrating that the anterior vaginal wall had both low sensitivity to electrical stimuli, low density of sensory receptors, and absence of nerve endings [1,2]. It was not until the early 1950s that the importance of the vagina, par- ticularly the anterior wall, was recognized for its role in sexual pleasure and orgasm. This realiza- tion is generally attributed to the German gyne- cologist Ernst Gräfenberg, who is credited with first describing the existence of an area of high sensitivity in the anterior vagina [3]. Interestingly, however, ancient Indian texts dating as far back as the 11th century, specifically the Kamas ´astra and Jayamangala scripts, describe a sensitive area in the vagina inducing sexual pleasure [4,5]. Even in Western culture, the idea of an ultrasensitive portion of the vagina predates Gräfenberg’s find- ings. Indeed, the Dutch physician and anatomist Regnier de Graaf, renowned for his contribution 1 © 2012 International Society for Sexual Medicine J Sex Med **;**:**–**