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Embryology, Anatomy, and Physiology of the Prostate
Published in Karl H. Pang, Nadir I. Osman, James W.F. Catto, Christopher R. Chapple, Basic Urological Sciences, 2021
Main tributary − deep dorsal vein of the penisDrains into the vesical plexus and internal pudendal vein, which drains into the vesical and internal iliac veins.
Physical Aspects of the Sex Response
Published in Philipa A Brough, Margaret Denman, Introduction to Psychosexual Medicine, 2019
Perineal veins generally accompany the corresponding arteries to connect via the internal pudendal veins, draining to the internal iliac vein. The deep dorsal vein of the penis/clitoris drains mainly the glans and corpora cavernosae, and travels along the midline, below the inferior pubic ramus to connect with a venous plexus surrounding the prostate in males and bladder in females.
Pelvic Floor Musculature
Published in Han C. Kuijpers, Colorectal Physiology: Fecal Incontinence, 2019
The ischiococcygeus arises from the tip of the ischial spine and its fibers fan outwards to be inserted into the lateral aspect of the coccyx and lower sacrum. This is almost certainly a vestigial muscle, with no recognizable specific function in man. The iliococcygeus muscle arises from the posterior aspect of the “white line” and its fibers are inserted into the lateral aspect of the coccyx and the anococcygeal raphe. The pubococcygeus arises from the anterior aspect of the “white line” and from the posterior aspect of the pubis. The majority of its posterior fibers extend posteriorly as a flat sheet lying superficial to the pelvic surface of the iliococcygeus to be inserted into the tip of the coccyx and the anococcygeal raphe. The puborectalis fibers arise more anteriorly from the body of the pubis and course medially and inferiorly joining with the fibers of the contralateral side to form a U-shaped sling which surrounds the anorectal junction. Contraction of these fibers is responsible for the creation of an acute angle between the lower rectum and upper anal canal; the so-called anorectal angle (see below). More medially, some fibers pass behind the prostate (in the male) into the perineal body. In the female the fibers pass behind the vagina to be inserted into the perineal body. It now seems highly probable that the puborectalis (as distinct from the remainder of the levator musculature) forms an integrated homogeneous unit with the external anal sphincter, since the two muscles seem to be continuous and functionally integrated.2,8 A small gap is increated between the most anterior aspects of the two levator muscles. This defect is filled by ligaments (pubo-prostatic ligaments in the male, pubovesical ligaments in the female) and by the deep dorsal vein of the penis (clitoris).
Effectiveness of Physiotherapy Interventions in the Management Male Sexual Dysfunction: A Systematic Review
Published in International Journal of Sexual Health, 2023
Caleb Ademola Omuwa Gbiri, Joy Chukwumhua Akumabor
Dorey et al. (2004) had a similar conclusion to Van Kampen and Geraerts (2015). Participants in their studies had ED of various etiology. The best results were however achieved in the group of participants with ED due to venous-occlusive dysfunction. In the Van Kampen and Geraerts (2015) study, 15 out of 20 participants with ED caused by venous-occlusive dysfunction reported a return of penile erection to allow satisfactory sexual intercourse. A physiologic explanation for the improvement of erectile dysfunction is a decrease in the venous outflow. Contractions of the ischiocavernosus and bulbocavernosus muscles produce an increase in the intracavernous pressure and influence penile rigidity. The bulbocavernosus muscle compresses the deep dorsal vein of the penis to prevent the outflow of blood from an engorged penis.
Serum testosterone status in men with penile corporoveno-occlusive dysfunction
Published in The Aging Male, 2020
Onder Canguven, Ahmad H. Al-Malki, Ahmad Majzoub
In the last decades of twentieth century, scientists investigated what they can do for ED. When the first results of penile deep dorsal vein ligation were published to treat CVOD [17], surgeons were motivated since there was a surgical treatment of a curable cause of ED. Later, plentiful techniques (e.g. deep dorsal vein ligation/excision [18,19], crural plication/ligation [20]) were published, but inclusion criteria, patient selection, and success evaluation differed extremely between study groups. Meanwhile, studies revealed that in patients who had ED due to CVOD, resection of the deep dorsal vein of the penis could provide a transient satisfactory result, and should not be considered as a long-term treatment modality [18,19,21]. Their data suggested that venous surgery should only be offered to a selected group of patients comprising young ED patients with CVOD [21,22]. Old age, neurogenic disorders causing ED, and diabetes mellitus were the main exclusion criteria for CVOD surgery [19,21,22].
Pathobiology of ischiocavernosus and bulbospongiosus muscles in long-term diabetic male rats and its implication on erectile dysfunction
Published in The Aging Male, 2020
Prakash Seppan, Ibrahim Muhammed, Zafar Iqbal Khan Mohammad, Sathya Bharathy Sathyanathan
The initiation and maintenance of penile erection depend on nerve control of the vasculature [25], concurrently, the integrity of the striated muscle system, i.e. ischiocavernosus (IC) and bulbospongiosus (BS) is mandatory for rigid erection. The penile bulb is surrounded by the BS, the penile crura and proximal part of the shaft by the IC [26,27]. The BS arises from the perineal body, and its anterior fibers end in a tendinous expansion, which extends over the dorsal aspect of the penis covering the dorsal vessels [26]. The BS assists in penile erection by compressing the erectile tissue of the penile bulb and the deep dorsal vein of the penis [28]. The IC arises from the ischial tuberosity and ramus, and its fleshy fibers end in an aponeurosis attached to the sides and undersurface of the crus penis [26]. The contractions of muscles on corporal tissue facilitate elevation of intracavernous pressure (ICP) that seems to be a reflex and mediated through the corpus cavernosum, which apparently leads to rigid erection [29]. Changes in the evoked response amplitude would indicate a defect in the reflex pathway. In the rigid erection phase, ICP may increase well above the systolic pressure due to IC and BS muscle contraction [30]. It has been noted that surgical removal of IC and BS leads to ED [31], indicating importance of IC and BS in penile erection.