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Embryology, Anatomy, and Physiology of the Male Reproductive System
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
The common penile artery divides into three branches (Figure 12.3):Bulbourethral, dorsal, and cavernosal artery.The cavernosal artery gives off helicine arteries which supply cavernous sinuses and vasodilate during penile tumescence.
Infertility Diagnosis and Treatment
Published in Sujoy K. Guba, Bioengineering in Reproductive Medicine, 2020
Adopting the above method the penile artery pressure may be obtained and related to the brachial artery pressure of the individual. Montague et al.52 observed that persons with normal erection response had penile systolic pressure about 20-mmHg below the brachial systolic pressure whereas those with diabetic vasculogenic impotence had a lower penile pressure with the difference between the brachial and penile pressures ranging between 50 to 70 mmHg. A penile-brachial index obtained by dividing the mean systolic pressure in the penile arteries by mean systolic pressure of the two brachial arteries has been defined.51 A value of this index less than 0.7 is suggestive of vasculogenic impotence.
Urethra and Penis
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The corpora cavernosa have an outer covering of tunica albuginea, which is relatively inelastic and which also forms the septum between them. The tunica albuginea encloses the erectile tissue itself, which has a trabecular structure with a network of sinusoidal spaces lined by endothelium within which the blood pools during erection. The central arterial blood supply (the central penile artery) is a branch of the internal pudendal artery. Erection occurs when the sacral parasympathetic nerves that innervate the penis cause smooth muscle relaxation with increased arterial inflow and dilatation of the sinusoids such that blood accumulates within the trabecular spaces.
Attitude towards sexuality and sexual behaviors among men with heart rhythm disorders
Published in The Aging Male, 2020
Rafal Mlynarski, Agnieszka Mlynarska, Krzysztof S. Golba
The relationship between erectile dysfunction and coronary artery disease (CAD) at the clinical level is supported by a common pathophysiological basis. The “artery size” hypothesis explains why CAD patients often report erectile dysfunction before detecting CAD [19]. According to this hypothesis, for a given atherosclerotic burden, the smaller penile arteries become blocked earlier than the larger coronary arteries. The same concept works well in the absence of stenoses in the coronary arteries – a smaller penile artery has a larger endothelial surface and an erection requires a high degree of vasodilation compared to the arteries in other organs; the same degree of endothelial dysfunction may be symptomatic in these smaller vessels, but they are subclinical in larger vessels (i.e. coronary) [20].
Effects of heart rate reduction with ivabradine on the international ındex of erectile function (IIEF-5) in patients with heart failure
Published in The Aging Male, 2018
Kadir Uğur Mert, Muhammet Dural, Gurbet Özge Mert, Kemal Iskenderov, Ata Özen
Endothelial dysfunction appears to be affecting not only the coronary but also almost all peripheral circulation [9,10]. The smaller penile artery has a greater endothelial surface and erection requires a large degree of vasodilation to occur when compared with arteries in other organs [11]. Thus, the penis is likely to be another end-organ affected by endothelial dysfunction and atherosclerosis in men [4,12]. However, endothelial dysfunction plays a role in ED in nonischemic cardiomyopathy without atherosclerosis [3]. Moreover, it was clearly demonstrated via the IIEF scores of 1549 patients that ED is a potent predictor of all-cause death and the composite of cardiovascular death, myocardial infarction, stroke and heart failure in men with cardiovascular disease [13].
Lower urinary tract symptoms/benign prostatic hyperplasia and erectile dysfunction: from physiology to clinical aspects
Published in The Aging Male, 2018
Aldo E. Calogero, Giovanni Burgio, Rosita A. Condorelli, Rossella Cannarella, Sandro La Vignera
The penile arterial supply displays slight variation in its anatomy. The penis is usually supplied by branches of the internal pudendal artery, which continue as the penile artery. The bulbar artery supplies the proximal shaft and is the first branch of the penile artery, which then divides into the dorsal and cavernosal arteries. The cavernosal artery enters and supplies the corpora cavernosa via several helicine arteries, which in turn flow into the sinusoids via multiple arterioles. The intercavernous septum is perforated, allowing for communication of blood (and injected pharmacological agents) across the midline. Emissary veins pierce the tunica albuginea to drain into the deep dorsal vein, via the spongiosal, circumflex and cavernosal veins [4] (Figure 1).