Nature and origin of "squirting" in female sexuality.

INTRODUCTION: During sexual stimulation, some women report the discharge of a noticeable amount of fluid from the urethra, a phenomenon also called "squirting." To date, both the nature and the origin of squirting remain controversial. In this investigation, we not only analyzed the biochemical nature of the emitted fluid, but also explored the presence of any pelvic liquid collection that could result from sexual arousal and explain a massive fluid emission. METHODS: Seven women, without gynecologic abnormalities and who reported recurrent and massive fluid emission during sexual stimulation, underwent provoked sexual arousal. Pelvic ultrasound scans were performed after voluntary urination (US1), and during sexual stimulation just before (US2) and after (US3) squirting. Urea, creatinine, uric acid, and prostatic-specific antigen (PSA) concentrations were assessed in urinary samples before sexual stimulation (BSU) and after squirting (ASU), and squirting sample itself (S). RESULTS: In all participants, US1 confirmed thorough bladder emptiness. After a variable time of sexual excitation, US2 (just before squirting) showed noticeable bladder filling, and US3 (just after squirting) demonstrated that the bladder had been emptied again. Biochemical analysis of BSU, S, and ASU showed comparable urea, creatinine, and uric acid concentrations in all participants. Yet, whereas PSA was not detected in BSU in six out of seven participants, this antigen was present in S and ASU in five out of seven participants. CONCLUSIONS: The present data based on ultrasonographic bladder monitoring and biochemical analyses indicate that squirting is essentially the involuntary emission of urine during sexual activity, although a marginal contribution of prostatic secretions to the emitted fluid often exists.

Screening for Down syndrome using first-trimester combined screening followed by second-trimester ultrasound examination in an unselected population.

OBJECTIVE: Recent studies have reported the efficacy of first-trimester combined screening for Down syndrome based on maternal age, serum markers (human chorionic gonadotropin, pregnancy-associated plasma protein A), and ultrasound measurement of fetal nuchal translucency. However, those do not incorporate the value of the widely accepted routine 20-22 weeks' anomaly scan. STUDY DESIGN: We carried out a multicenter, interventional study in the unselected population of a single health authority in order to assess the performance of first-trimester combined screening, followed by routine second trimester ultrasound examination and/or screening by maternal serum markers (free beta-hCG and alpha-fetoprotein measurement or total hCG, alpha-fetoprotein, and unconjugated estriol measurement) when incidentally performed. Detection and screen positive rates were estimated using a correction method for nonverified issues. A cost analysis was also performed. RESULTS: During the study period, 14,934 women were included. Fifty-one cases of Down syndrome were observed, giving a prevalence of 3.4 per 1000 pregnancies. Of these, 46 were diagnosed through first (n = 41) or second (n = 5) trimester screening. Among the 5 screen-negative Down syndrome cases, all were diagnosed postnatally after an uneventful pregnancy. Detection and screen positive rates of first-trimester combined screening were 79.6% and 2.7%, respectively. These features reached 89.7%, and 4.2%, respectively, when combined with second-trimester ultrasound screening. The average cost of the full screening procedure was 108 euros (120 dollars) per woman and the cost per diagnosed Down syndrome pregnancy was 7,118 euros (7909 dollars). CONCLUSION: Our findings suggest that 1 pragmatic interventional 2-step approach using first-trimester combined screening followed by second-trimester detailed ultrasound examination is a suitable and acceptable option for Down syndrome screening in pregnancy.

Changes in progesterone-induced-blocking-factor expression rates following mifepristone administration in termination of pregnancy at 5 to 8 weeks.

OBJECTIVE: To study changes in the expression rate of PIBF by peripheral lymphocytes in healthy pregnant women after administration of mifepristone for non-surgical termination of pregnancy at 5-8 wks of gestation. METHODS: Patients requesting early social termination of pregnancy, in a 3-month period, were included. A first venous blood sample was taken before oral administration of 600 mg of mifepristone (day 0). A second venous blood sample was taken 2 days later. PIBF on lymphocytes was determined by immunocytochemistry using a PIBF-specific polyclonal antibody. RESULTS: Termination of pregnancy was successful and complete in all cases. In 17 out of 21 patients, the percentage of PIBF positive lymphocytes decreased after anti-progesterone administration. The percentage of PIBF-expressing lymphocytes significantly decreased from 52.8%+/-21.6% (day 0) to 39.8%+/-18.2% by day 2 (p=0.001). CONCLUSIONS: These data suggest a strong relationship between early termination of pregnancy induced with mifepristone and disturbances of progesterone-mediated immunosuppression.