Penis and Urethra


IMAGING ANATOMY

Penis

  • Composed of 3 cylindrical shafts

    • 2 corpora cavernosa : Main erectile bodies

      • On dorsal surface of penis

      • Diverge at root of penis ( crura ) and are invested by ischiocavernosus muscles

      • Chambers traversed by numerous trabeculae, creating sinusoidal spaces

      • Multiple fenestrations between corpora, creating multiple anastomotic channels

    • 1 corpus spongiosum : Contains urethra

      • On ventral surface, in groove created by corpora cavernosa

      • Becomes penile bulb at root and is invested by bulbospongiosus muscle

      • Forms glans penis distally

      • Also erectile tissue but of far less importance

  • Tunica albuginea forms capsule around each corpora

    • Thinner around spongiosum than cavernosa

  • All 3 corpora surrounded by deep fascia ( Buck fascia ) and superficial fascia ( Colles fascia )

  • Main arterial supply from internal pudendal artery

    • Cavernosal artery runs within center of each corpus cavernosum

      • Gives off helicine arteries , which fill trabecular spaces

      • Primary source of blood for erectile tissue

    • Paired dorsal penile arteries run between tunica albuginea of corpora cavernosa and Buck fascia

      • Supplies glans penis and skin

  • Venous drainage of corpora cavernosa

    • Emissary veins in corpora pierce through tunica albuginea → circumflex veins → deep dorsal vein of penis → retropubic venous plexus

    • Superficial dorsal vein drains skin and glans penis

Normal Erectile Function

  • Neurologically mediated response eliciting smooth muscle relaxation of cavernosal arteries, helicine arteries, and cavernosal sinusoids

  • Blood flows from helicine arteries into sinusoidal spaces

  • Sinusoids distend, eventually compressing emissary veins against rigid tunica albuginea

    • Venous compression prevents egress of blood from corpora, which maintains erection

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