Distal Ligament in Human Glans: A Comparative Study of Penile Architecture

Hsu, Geng‐Long; Lin, Chao-Wen; Hsieh, Cheng‐Hsing; Hsieh, Ju-Ton; Chen, Shyh-Chyan; Kuo, Ting‐Shen; Ling, Pei-Ying; Huang, H.; Wang, Chii‐Jye; Tseng, Guo‐Fang

doi:10.2164/jandrol.04145

Cited by 32 publications

(25 citation statements)

References 13 publications

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“…Erection and eversion by hydrostatic pressure and muscle contraction function to achieve turgor and to create a functional channel for sperm transfer [Hart and Melese-D'Hospital, 1983;Schmidt and Schmidt, 1993;Andersson and Wagner, 1995;Kelly, 2002Kelly, , 2004Kelly, , 2013Hsu et al, 2005;Cabrera et al, 2007]. Hydrostatic pressure is produced by blood vasculature in penises of crocodilians, turtles and mammals [Zug, 1966;King, 1979;Kelly, 2004;Moore et al, 2012], by lymphatic vessels in bird penises, when present [King, 1979], and by both blood and lymph in squamates [Dowling and Savage, 1960].…”

mentioning

confidence: 99%

Morphogenesis and Patterning of the Phallus and Cloaca in the American Alligator, Alligator mississippiensis

Gredler¹,

Seifert²,

Cohn³

2014

Sex Dev

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In most animals, reproduction by internal fertilization is facilitated by an intromittent organ, such as the penis in amniote vertebrates. Recent progress has begun to uncover the mechanisms of mammalian external genital development; however, comparatively little is known about the development of the reptilian penis and clitoris. Here, we describe the development of the phallus and cloaca in the American alligator, Alligator mississippiensis. The embryonic precursor of the penis and clitoris is the genital tubercle, which forms by the budding of genital mesenchyme beneath the ventral body wall ectoderm, adjacent to the cloacal membrane. The cloacal lips develop from another pair of outgrowths, the lateral swellings. Early development of the alligator phallus, cloaca, and urogenital ducts generally resembles that of other reptiles, suggesting that differences in adult reptilian phallus and cloacal anatomy arise at later stages. The phallic sulcus is derived from the cloacal endoderm, indicating that the crocodilian sulcus is functionally and developmentally homologous to the mammalian urethra. Initial external genital outgrowth and patterning occur prior to temperature-dependent sex determination. Our analysis of alligator phallus and cloaca development suggests that modifications of an ancestral program of urogenital development could have generated the morphological diversity found in the external genitalia of modern amniotes.

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mentioning

confidence: 99%

Morphogenesis and Patterning of the Phallus and Cloaca in the American Alligator, Alligator mississippiensis

Gredler¹,

Seifert²,

Cohn³

2014

Sex Dev

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“…A full exploration of the penile anatomy among animal species provides the framework for an investigation into the processes of species-level divergence [30]. In quadrupeds, such as dogs and rats, an os penis – supported by a pair of well-developed, non-elastic corpora – forms an unvarying and indispensible component of the penis, vital to intercourse.…”

Section: The Os Penis In Quadrupeds and The Distal Ligament In An Uprmentioning

confidence: 99%

physiology: Clinical implications for physicians and surgeons

et al. 2012

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SummaryRecent 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.

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“…A bloody aspiration denotes that the corpus spongiosum is entered. An experienced hand can feel if an inadvertent puncture through the tunica has been made, since the bony-like tunica (Hsu et al, 2005) can act as a barrier in providing an intermediate resistance. An injection of a 2-3-mL solution is sufficient to block the nervous fiber of the cavernous nerve.…”

Section: Anesthesia Ii: Crural Block and Ventral Infiltrationmentioning

confidence: 99%

The Advancement of Pure Local Anesthesia for Penile Surgeries: Can an Outpatient Basis Be Sustainable?

Hsu

Hsieh

Chen

et al. 2007

Journal of Andrology

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Although topical anesthetic blockage for penile surgeries has been substantially reported in the medical literature, its methodology, reliability, and reproducibility have not been consistent. We report on several methods of topical blocks for local anesthesia in patients with indications for penile surgeries. From March 1993 to March 2003, a total of 1131 men, ages 19 to 87, underwent penile surgeries in which 165, 203, 708, 45, and 10 patients received penile implantation, modified Nesbit procedure, venous surgery, venous patches, and arterial revascularization respectively, under pure local anesthesia on an outpatient basis. They were categorized into the implant, Nesbit, venous, patch, and arterial groups respectively. Proximal dorsal nerve blockage, peripenile infiltration, and topical injection, although challenging, were sufficient local anesthesia for patients in the last 4 patient groups. A new method of crural blockade, however, was also required for optimal anesthesia of the cavernous nerve for implantation purposes.The anesthetic effects and postoperative results were satisfactory. Common immediate side effects included puncture of the corpus spongiosum or the deep dorsal vein as well as the innominate vessel, subcutaneous ecchymosis, transient palpitations, and acceptable low level of pain. There were no significant late complications. In the implant group, however, 6.1% of patients (10/165) had experienced pain over the perineum for 1 to 2 weeks postoperatively. Overall there were statistical differences in scoring between the 5 groups in which the implant group stood out when a visual analog scale of 100 mm was used. Topical nerve blockades proved to be reliable, simple, and safe, with minimal complications. They offer the advantages of less morbidity, reduced effects of anesthesia, protection of privacy, and a rapid return to preoperative daily activity.

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Distal Ligament in Human Glans: A Comparative Study of Penile Architecture

Cited by 32 publications

References 13 publications

Morphogenesis and Patterning of the Phallus and Cloaca in the American Alligator, <b><i>Alligator mississippiensis</i></b>

Morphogenesis and Patterning of the Phallus and Cloaca in the American Alligator, <b><i>Alligator mississippiensis</i></b>

physiology: Clinical implications for physicians and surgeons

The Advancement of Pure Local Anesthesia for Penile Surgeries: Can an Outpatient Basis Be Sustainable?

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