Unit 2- The Penis

What is the arterial pathway of the penis?

1. common iliac arteries

2. internal iliac arteries

3. internal pudendal arteries

   -deep artery of the penis -bulbourethral artery

   -corpora cavernosa -corpus spongiosum

What is the venous pathway of the penis?

1. deep dorsal vein -superficial dorsal vein

2. pudendal venous plexus

3. internal pudendal veins

4. internal iliac veins

5. common iliac veins

The penis stimulation increases

blood supply

-dilated arteries

The penis engorged blood sinuses within the

corpora cavernosa

Compression of veins

-retains blood for erection

-urinary bladder sphincter closes

What is the reproductive function of the penis?

is to eject semen

-insertion/delivery in the vagina

What are the penile sonography applications?

-evaluation of vasculogenic impotence

-detection of fibrosis- Peyronie’s disease

-detection of scar tissue and plaques

-evaluation of tumors

-penile hematomas

-evaluate periurethral disease or stricture

What is the sonographic appearance of the corpus spongiosum?

homogeneous medium level echoes

What is the sonographic appearance of the corpora cavernosa?

homogeneous medium level echoes

What is the sonographic appearance of the tunica albuginea and septum penis?

highly echogenic

What is Peyronie’s Disease

development of fibrous scar tissue inside the penis

What are the effects of peyronie’s disease?

-causes a significant bend

-erection problems

-shortening of the penis

-pain

-treat if severe enough to prevent successful intercourse

What are the causes of peyronies disease?

-repeated injury

-unknown etiology

What are these images showing?

peyronies

Penile Doppler Eval measurements of cavernosal artery

arterial diameter

baseline PSV and EDV

Penile Doppler Eval

pre-injection (papaverine) baseline

-evaluated through the 5 phases of erection

-post injection 5, 10, 15, 20 minutes

What is the PSV?

<30 cm/sec indicated arteriogenic impotence

What is EDV?

>5cm/sec indicates venogenic impotence

-Reverse diastole rules out venous insufficiency