Physiology and Management of Erectile Dysfunction

Anatomy and Physiology

The physiology of erections is a complex interaction between the penile anatomical compartments, vessels and nerves. The penile anatomical compartments involved in erections are principally the corpora cavernosa. These are paired cylinders of smooth muscle encased in the tunica albuginea which function as the erection chambers and are separate from the glans penis (see Figure 1). The blood supply comes from the internal pudendal artery which separates into 3-4 branches into the penis. Just beneath the tunica albuginea is the subtunical venous plexus which drains into emissary veins and eventually forms the dorsal veins of the penis. The autonomic nervous system plays an integral role with parasympathetic nerves involved in tumescence and the sympathetic nerves controlling detumescence.

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