(062) The Physiological Health of the Penile Fibro-Vascular Assembly Requires the Integrity of Ten Fibro-ligaments in the Human Penis

Abstract

Abstract Introduction Although the human penis has existed on earth for 3000 centuries and extensive studies have been conducted for many recent centuries, there is still room for improvement, particularly in the fibro-ligaments' role in maintaining physiological sexual health. Thus far, there needs to be more interpretation concerning these ligaments. Objective We aimed to explore the penile fibrous ligaments thoroughly to fill this research gap. Methods We excluded cadaveric penises that had both sides of the corpora cavernosa (CC) and corpus spongiosum (CS) damaged. However, penises with one undamaged side of the CC, including the Colles' fascia and the corpus spongiosum, were included. A total of 15 out of 46 penises were meticulously examined. Dissection findings were supplemented with 101 cadaveric photos and data from 263 penile vascular surgeries, 11 CT imaging scans, 8 MRI imaging scans, eight hypospadias surgeries, and eight penile elongation surgeries performed elsewhere internationally. Results Bilaterally, the penile CC is primarily anchored to the pelvis wall through the unilateral cavernosal ligament bilaterally (CL=2), while the CS is connected to the urinary sphincter. The suspensory, fundiform, and arcuate pubic ligament (two anatomically and one functionally) assist in stabilizing and holding the penile shaft to the pelvic wall. Distally, a distal ligament (DL=1) and spongiosal ligament (SL=1) extend the CC and CS to the glans penis and frenulum, ensuring urethra patency when required. The CC is encircled by a bi-layered tunica consisting of a 360° inner circular tunica and a 300° outer longitudinal coat. The ischiocavernosus muscle wraps around the penile crus and envelops the CL connecting to the ischial tuberosity. The CS is partially secured by the bulbospongiosus muscle proximally and receives the SL distally. The entire penis interconnects with the skeletal muscle of the urogenital diaphragm eventually. Conclusions The physiologically sexual health of the human penis's hydraulic system relies on the integrity of ten anatomically and six functionally fibro-muscular ligaments. Disclosure No.