title: Advances in understanding of mammalian penile evolution, human penile anatomy and human erection physiology: clinical implications for physicians and surgeons.
abstract: Recent studies substantiate a model of the tunica albuginea of the corpora cavernosa as a bi-layered structure with a 360° complete inner circular layer and a 300° incomplete outer longitudinal coat spanning from the bulbospongiosus and ischiocavernosus proximally and extending continuously into the distal ligament within the glans penis. The anatomical location and histology of the distal ligament invites convincing parallels with the quadrupedal os penis and therefore constitutes potential evidence of the evolutionary process. In the corpora cavernosa, a chamber design is responsible for facilitating rigid erections. For investigating its venous factors exclusively, hemodynamic studies have been performed on both fresh and defrosted human male cadavers. In each case, a rigid erection was unequivocally attainable following venous removal. This clearly has significant ramifications in relation to penile venous surgery and its role in treating impotent patients. One deep dorsal vein, 2 cavernosal veins and 2 pairs of para-arterial veins (as opposed to 1 single vein) are situated between Buck's fascia and the tunica albuginea. These newfound insights into penile tunical, venous anatomy and erection physiology were inspired by and, in turn, enhance clinical applications routinely encountered by physicians and surgeons, such as penile morphological reconstruction, penile implantation and penile venous surgery.
authors: Division of Urology, Buddhist Tzu-Chi General Hospital, Taipei Branch, Department of Urology, School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan.
authors: Cheng-Hsing
authors: CH
authors: Hsieh
authors: Shih-Ping
authors: SP
authors: Liu
authors: Geng-Long
authors: GL
authors: Hsu
authors: Heng-Shuen
authors: HS
authors: Chen
authors: Eugen
authors: E
authors: Molodysky
authors: Ying-Hui
authors: YH
authors: Chen
authors: Hong-Jeng
authors: HJ
authors: Yu
mesh_terms: D000818:Animals; D005075:Biological Evolution; D007172:Erectile Dysfunction / Q000503:physiopathology; D006801:Humans; D008297:Male; D008322:Mammals / Q000033:anatomy & histology* / Q000502:physiology*; D010410:Penile Erection / Q000502:physiology*; D010413:Penis / Q000033:anatomy & histology* / Q000502:physiology* / Q000601:surgery; D010820:Physicians