title: Penile veins are the principal component in erectile rigidity: a study of penile venous stripping on defrosted human cadavers.
abstract: The human erectile mechanism is an intricate interplay of hormonal,  vascular, neurological, sinusoidal, pharmacological, and psychological  factors. However, the relative influence of each respective component remains  somewhat unclear, and merits further study. We investigated the role of venous  outflow in an attempt to isolate the key determinant of erectile function.  Dynamic infusion cavernosometry and cavernosography was conducted on 15  defrosted human cadavers, both before and after the systematic removal and  ligation of erection-related penile veins. Preoperatively, an infusion rate of  more than 28.1 mL/min (from more than 14.0 to 85.0 mL/min) was required to  induce a rigid erection (defined as intracavernosal pressure [ICP] exceeding  90 mmHg). Following surgery, we were able to obtain the same result at a rate  of 7.3 mL/min (from 3.1 to 13.5 mL/min) across the entire sample. Thus, we  witnessed statistically significant postoperative differences (all P  ≤ .01), consistently elevated ICP, lower perfusion volumes, and a general  reduction in time taken to attain rigidity. The cavernosograms provided  further evidence substantiating the critical role played by erection-related  veins, whereas histological samples confirmed the postoperative integrity of  the corpora cavernosa. Given that our use of cadavers eliminated the influence  of hormonal, arterial, neurological, sinusoidal, pharmacological, and  psychological factors, we believe that our study demonstrates that the human  erection is fundamentally a mechanical event contingent on venous  competence.
authors.affiliation: Microsurgical Potency Reconstruction and Research Center, Hsu's Andrology, Taipei, Taiwan. genglonghsu@gmail.com
authors.forename: Geng-Long
authors.initials: GL
authors.lastname: Hsu
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Hung
authors.forename: Mang-Hung
authors.initials: MH
authors.lastname: Tsai
authors.forename: Cheng-Hsing
authors.initials: CH
authors.lastname: Hsieh
authors.forename: Heng-Shuen
authors.initials: HS
authors.lastname: Chen
authors.forename: Eugen
authors.initials: E
authors.lastname: Molodysky
authors.forename: Chi Can
authors.initials: CC
authors.lastname: Huynh
authors.forename: Hong-Jeng
authors.initials: HJ
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D007172:Erectile Dysfunction / Q000503:physiopathology; D006801:Humans; D008026:Ligation; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D010413:Penis / Q000098:blood supply*; D014680:Veins / Q000601:surgery