A study of the arterial blood supply to the penis

Abstract

Summary. Two arterial systems contribute to the blood supply of the penis. The deeper system, responsible for supplying the erectile tissues, arises from the internal pudendal arteries (a. pudendae internae), or sometimes from an accessory internal artery. Four branches, either collateral or terminal, should be considered: the artery to the bulb of the penis, the urethral artery, the deep artery of the penis and the dorsal artery of the penis. Variations are frequently present in the origin, distribution and symmetry of these arteries, but on the whole the blood supply is organised into three planes, inferior or ventral, middle and deep, superior or dorsal. These three planes are complementary: when the blood supply to any one of them is occluded, at whatever level this may be, the blood supply is supplemented by the plane immediately above it. Arteriograms should be interpreted with caution because anatomical variations may at first sight be taken for pathological change.The superficial system, supplying the tissues around the erectile organs, arises from the lateral inferior pudendal arteries. Three types of supply have been described, according to whether the right and left arteries have a symmetrical distribution or whether the arterial network arises in large part or totally from one side. Contribution fi l'6tude de la vaseularisation art&idle du p6nisR6sum& Deux syst~mes art6riels participent fi la vascularisation du p6nis. Le syst6me profond, tenant sous sa d6pendance les organes 6rectiles, a pour origine les art6res honteuses internes (a. pudendae internae), parfois une art6re interne accessoire. Quatre branches, collat~rales ou terminales sont Offprint requests to: S Juskiewenski /t consid6rer: l'art6re du bulbe du p6nis, l'art6re ur6trale, l'art6re profonde du p6nis, l'art6re dorsale. I1 existe de fr6quentes variations dans l'origine, la distribution et la sym&rie de ces art6res mais, dans son ensemble, la vascularisation est organis6e selon trois plans, inf6rieur ou ventral, moyen ou profond, sup6rieur ou dorsal. Ces trois plans sont compl6mentaires: lorsque l'un d'eux s'6puise, fi quelque niveau que ce soit, le relais est pris par le plan imm6diatement sup6rieur.Le syst6me superficiel, vascularisant les enveloppes provient des art6res honteuses externes inf6rieures. Trois types de vascularisation sont d6-crits, selon que tes deux art6res droite et gauche ont une distribution sym6trique ou que le r6seau art6riel provient en majeure partie ou totalement d'un seul c6t6.

Color Doppler appearance of penile cavernosal–spongiosal communications in patients with normal and impaired erection

“…No agreement has been reached about the behavior of these vessels within the corpus spongiosum. Whereas Wagner et al assess that these vessels are shunts connecting the cavernosal artery with the sinusoidal spaces of the corpus spongiosum [4], more recent studies suggest that they are arterial anastomoses connecting the cavernosal artery with the urethral arterial network [5,6].…”

Cavernospongious Shunts: Anatomical Study of Intrapenile Vascular Pathways

“…A key question is whether they are arteriovenous shunts or arterial anastomoses. In an arteriographical anatomical study on postmortem specimens, Juskiewenski et al [11] described three complementary layers of arterial supply to the penis asserting that anastomoses exist between the dorsal artery, the cavernous artery and the urethral artery, each one of them being able to supply each corpora. This functional hypothesis has no physiological support and contested data exist concerning the direction of the flow in connecting vessels during flaccidity and erection.…”

What is the origin of the arterial vascularization of the corpora cavernosa? A computer‐assisted anatomic dissection study

“…Erdogru et al (2001), once again through Doppler studies, has shown that these dorsocavernous anastomoses played an important role in intracavernous arterial hemodynamics in 28% of patients with erectile dysfunction. In two-thirds of 40 penile specimens, Juskiewenski et al (1982) had found one or several accessory cavernous arteries originating from the dorsal arteries. He also remarked that the dorsal artery could terminate as the cavernous accessory artery.…”