Mechanisms of veno-occlusion within and outside the canine corpus cavernosum penis using a pressure-flow technique and cavernoso-venography.

BACKGROUND

Physiological erection of the penis requires multiple mechanisms causing an increase in the arterial blood influx into, and decrease in the venous drainage out of the cavernous space.

METHODS

We investigated the extent and location of the venous occlusion that occurs with penile erection within (intrinsic mechanism) and outside (extrinsic mechanism) the corpus cavernosum penis, using 15 adult male mongrel dogs. Under controlled flows produced by a combination of aortic ligation and constant infusion of saline into the corpus cavernosum penis, or into the deep dorsal vein, pressures within the cavernous space or deep dorsal vein were measured before and after electrical stimulation of the pelvic splanchnic (pelvic nerve), the hypogastric, and pudendal nerve. An increase in pressure following nerve stimulations represented an increase in outflow resistance due to occlusion of the venous system. Pre-and post-stimulation radiologic evaluations were performed to determine the site(s) of venous occlusion.

RESULTS

Unilateral stimulation of the pelvic nerve caused leftward shift of the corporeal pressure-flow curve. Bilateral stimulation of the pudendal nerve caused a marked rise in deep dorsal vein pressure.

CONCLUSIONS

Both intrinsic and extrinsic venous occlusion mechanisms exist and that the former is activated primarily by unilateral stimulation of the pelvic nerve and the latter by bilateral stimulation of the pudendal nerve. The occlusion site for the extrinsic mechanism was localized to where the dorsal vein penetrates the muscles at the base of the pelvis, whereas the precise site for the intrinsic mechanism could not be determined.