Electrophysiologic Activity of the Tunica Albuginea and Corpora Cavernosa: Possible Role of Tunica Albuginea in the Erectile Mechanism

Abstract

Introduction It is claimed that the tunica albuginea (TA) shares in the erectile mechanism by compressing the emissary veins passing through it. However, the TA does not contain smooth muscle fibers. Aim We investigated the hypothesis that TA lacks a contractile activity on the emissary veins passing through it. Methods Fourteen healthy male volunteers (mean age 35.2 ± 4.3 years) were studied. The electromyographic (EMG) activity of the TA and corpora cavernosa (CC) was individually recorded in the flaccid and erectile phases by EMG needle electrodes. Recording was performed in the upper, middle, and lower third of the TA and CC on one and then on the contralateral side. Main Outcome Measures The TA lacks a contractile activity on the emissary veins passing through it. Results The EMG of the CC in the flaccid phase recorded regular slow waves and random action potentials. The wave variables in the erectile phase exhibited a significant decrease (P <0.01) compared with the variables in the flaccid phase of the same subject. The TA EMG showed no electric waves in the flaccid or erectile phases. These recordings were similar from the upper-, middle-, and lower-third of the penis, and were reproducible from the contralateral CC. Conclusion Electric waves were recorded from the CC in the flaccid phase; wave variables decreased at erection. In contrast, the TA showed no electric waves in the flaccid or erectile phases. It appears that the TA acts as a CC covering sheet which expands passively at erection, and shares in compressing the subtunical venular plexus between it and the tumescent CC.

On The Etiology of the Electric Activity of the External Anal and Urethral Sphincters

“…Previous studies have shown that the gut possesses an electric activity, which is suggested to originate from the smooth muscle fibers and to be responsible for the tonic contraction of the gut [9][10][11][12][13][14][15][16][17]. The smooth muscles have a resting electric activity, which appears to create the smooth muscle tone [18].…”

Treatment of Penile Deep Dorsal Venous Leakage of Erectile Dysfunction by Embedding the Deep Dorsal Vein of the Penis: A Single Center Experience with 17 Patients

“…It is reported that approximately 80% of the men with vasculogenic erectile dysfunction (ED) have evidence of failure to store blood (venous leakage) within the corpora cavernosa [1]. Venogenic ED (VED) may be caused by the formation of large venous channels draining the corpora cavernosa, degenerative changes to the tunica albuginea, structural alterations of the cavernous smooth muscle and endothelium [2–13]. Whatever the cause, the main goal of treatment is to occlude this venous outflow [8–10,14–17].…”

“…Venogenic ED (VED) may be caused by the formation of large venous channels draining the corpora cavernosa, degenerative changes to the tunica albuginea, structural alterations of the cavernous smooth muscle and endothelium [2][3][4][5][6][7][8][9][10][11][12][13]. Whatever the cause, the main goal of treatment is to occlude this venous outflow [8][9][10][14][15][16][17].…”