Current methods for assessing erogenous sensation: implications for sensory outcomes in genital gender-affirming surgery.

Introduction: Preserving erogenous sensation is essential for postoperative sexual function and patient satisfaction following gender-affirming surgery. However, the biological basis of erogenous sensation and its assessment methods are not well understood.

Objective: This review summarizes the current mechanistic understanding of erogenous sensation and identifies existing knowledge gaps for future research.

Methods: Three databases were queried from their inception to December 2022 for full-text English articles investigating erogenous sensation. Two independent reviewers screened the studies, and key results were extracted. The findings were compiled to discuss erogenous sensation, organized into neurophysiologic mechanisms, assessment modalities, and the sensibility of different erogenous territories.

Results: Of the 143 included studies, 46 (32%) articles investigated the physiology of erogenous sensation. Of those, 13 (28%) studies focused on the brain regions involved in processing erogenous sensations. Most studies (92 [64%]) assessed erogenous sensation following a procedure. Among this group, 53 (58%) studies relied only on subjective patient-reported outcomes (ie, survey, visual analog scale, etc.). Only 22 (24%) studies used objective assessment modalities such as vibrotactile detection thresholds and vaginal photoplethysmography.

Conclusion: Significant gaps remain in the understanding and assessment of erogenous sensation. Current research is limited by methodological inconsistencies and a lack of standardized, objective measurement tools. Future efforts should prioritize developing validated assessment methods and conducting longitudinal studies to enhance sensory outcome evaluation in gender-affirming surgery.