Skip to main content
SpringerLink
Log in

The anatomy of erection

Anatomie de l'érection

  • Original Articles
  • Published:
Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Summary

Erection is due to a neurovascular mechanism: an inflow of arterial blood and an obstruction of venous return. The direction of this mechanism is of neurologic origin: (1) control of the smooth muscle tissue of the corpora cavernosa by the autonomic system controlled by reflex centers in the cord or cortical centers accessible to multiple (visual) stimuli (2) control of the perineal muscles by the somatic system. Tumescence is due to a reduction in the alpha-sympathetic tonus of the cavernous tissue permitting influx of arterial blood, and to decreased venous flow from compression of the subalbugineal venous network against the tunica albuginea of the corpus cavernosurn. Once this obstruction to the venous return has been achieved, the arterial flow in the corpora cavernosa decreases but persists; the arterial blood in the corpora cavernosa is renewed and not shut off. Rigidity is due to an increase in intracavernous arterial pressure simultaneous with contraction of the perineal muscles (ischiocavernosus) under the somatic control of the pudendal nerve.

Résumé

L'érection est due à un mécanisme vasculonerveux: vasculaire par l'apport de sang artériel et le freinage du retour veineux; la commande de ce mécanisme est d'origine nerveuse: contrôle du tissu musculaire lisse des corps caverneux par le système végétatif contrôlé par des centres médullaires réflexes ou corticaux acessibles à des stimulations multiples (visuelles); contrôle des muscles périnéaux par le système somatique. La tumescence est due à une réduction du tonus alpha-sympathique du tissu caverneux qui permet l'afflux de sang artériel, à une réduction du flux veineux par une compression du réseau veineux sous-albuginée par l'albuginée du corps caverneux. Lorsque cette gêne au retour veineux est réalisée, le flux artériel dans les corps caverneux diminue mais persiste; il existe un renouvellement du sang artériel sans séquestration dans les corps caverneux. La rigidité est due à une augmentation de la pression artérielle intra-caverneuse concomitante de la contraction des muscles périnéaux: ischio-caverneux, sous contrôle somatique par le nerf honteux.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Adarkan PG, Kottegoda SR, Ratnam SS (1986) Is vasoactive intestinal polypeptide the principal transmitter involved in human penile erection. J Urol 135: 638

    PubMed  Google Scholar 

  2. Alvarez-Marijo (1967) Terminal arteries of the penis. Acta Anat (Basel) 67: 387

    Google Scholar 

  3. Benoit G, Al Youssef I, Richard F, Jardin A (1986) Etude neuro-anatomique de la miction. Ann Urol 20, 3: 158

    Google Scholar 

  4. Benson G, Mc Connel JA, Schmidt WA (1981) Penile polster: functional structures for atherosclerotic changes. J Urol 125: 800

    PubMed  Google Scholar 

  5. Berendsen HMG, Gower AJ (1986) Opiate-androgen interactions in drug induced yawning and penile erections in rat. Neuroendocrinology 42: 185

    PubMed  Google Scholar 

  6. Bergman B, Nilsson S, Petersen I (1979) The effect on erection and orgasm of cystectomy, prostatectomy and vesiculectomy for cancer of the bladder: a clinical and electromyographic study. Br J Urol 51: 114

    PubMed  Google Scholar 

  7. Blum MD, Bahnson RR, Porter TN, Carter MF (1985) Effect of local alpha adrenergic blockade on human penile erection. J Urol 134, 3: 479

    PubMed  Google Scholar 

  8. Bors E, Comarr AE (1960) Neurological disturbance of sexual function with special reference to 529 patients with spinal cord injury. Urol Survey 10: 191

    Google Scholar 

  9. Brennen GE, Kempczinski RF, Peters TG, Schroter GPJ, Hambidge KM, Weil R, Kumpe DA (1980) Impotence after kidney transplantation. Urol 15: 138

    PubMed  Google Scholar 

  10. Buvat J, Lemaire A, Buvat Herbaut M, Furlinnie JC, Racadot A, Fossati P (1985) Horm Res 22, 3: 196

    PubMed  Google Scholar 

  11. Buvat J, Lemaire A, Debaene IL, Buvat Herbaut M, Guien JD (1986) Venous incompetence: critical study of the organic basis of high maintenance flow rates during artificial erection test. J Urol 135: 926

    PubMed  Google Scholar 

  12. Calabrisi P (1956) The nerve supply of the erectile cavernous tissue of genitalia in the human embryo and fetus. Anat Rec 125: 713.

    PubMed  Google Scholar 

  13. Carati CJ, Goldre RG, Warton A, Henry PJ, Keogh EJ (1985) Pharmacology of the erectile tissue of the canine penis. Pharmacol Res Commun 17, 10: 951

    PubMed  Google Scholar 

  14. Clark JT, Smith ER, Davidson JM (1984) Enhancement of sexual motivation in male rats by yohimbine. Science 225, 4: 847

    PubMed  Google Scholar 

  15. McConnell J, Benson GS, Wood J (1979) Autonomic innervation the mammalian penis: a histochemical and physiological study. J Neural Transm 45: 227

    PubMed  Google Scholar 

  16. Conti G (1952) L'érection du pénis humain et ses bases morphologico-vasculaires. Acta Anat 24, 3: 217

    Google Scholar 

  17. Cordier P, Coulouma (1933) Les nerfs érecteurs. Bull Assoc Anat 143

  18. Delmas J, Laux G (1933) Anatomie médico-chirurgicale du système nerveux végétatif. Masson et Cie, Paris

    Google Scholar 

  19. Dhabuwala CB, Ramakrishna CV, Anderson GF (1985) Betaadrenergic receptors in human cavernous tissue. J Urol 133: 721

    PubMed  Google Scholar 

  20. Doremieux J (1985) Hémodynamique de l'érection. Nouvelles données pharmacologiques. Ann Urol 19, 5, 327

    Google Scholar 

  21. Eckhard C (1863) Untersuchungen über die erection des penis beim hunde. Beitr Anat Physiol 3: 123

    Google Scholar 

  22. Ferrari F. Behavioural pharmacology of imidazole, a potential antidepressant agent. Arch Int Pharmacodyn Ther 227, 2: 303

  23. Foldes P (1982) La cystectomie totale radicale pour cancer de la vessie: étude critique d'une série homogène de deux cents cas. Thèse Paris

  24. Fournier CR, Juenemann KP, Lue TF, Tanagho EA (1987) Mechanismes of venous occlusion during canine penile erection: an anatomic demonstration. J Urol 137: 163

    PubMed  Google Scholar 

  25. Francois Franck M (1898) Recherche sur l'innervation vasomotrice du pénis. Topographie des nerfs constricteurs et dilatateurs. Arch Physiol Norm Pathol 27: 138

    Google Scholar 

  26. GilVernet S (1964) Innervation somatique et végétative des organes génito-urinaires. Acta Urol Belg 32: 265

    PubMed  Google Scholar 

  27. Gittes RF, Waters WB (1979) Sexual impotence: the overlooked complication of a second renal transplant. J Urol 121: 719

    PubMed  Google Scholar 

  28. Godec CJ, Bates H (1984) Cholinergic receptors in corpora cavernosa. Urol 24, 1: 31

    PubMed  Google Scholar 

  29. Godec CJ, Bates H, Labrosse K (1985) Testosterone receptors in corpora cavernosa of penis. Urol 26: 237

    PubMed  Google Scholar 

  30. Gold FM, Hotchkiss RS. Sexual potency following simple prostatectomy. NY State J Med 69: 2987

  31. Goldstein AMB, Morrow JW, Meehan JP, Buckley PA, Rogers FA (1984) Special micro-anatomical features surrounding the intracorpora cavernosa nerves and their probable function during erection. J Urol 132: 44

    PubMed  Google Scholar 

  32. Goldstein AMB, Meehan JP, Zakhery R (1984) Penile posters: functional structures for atherosclerotic changes. J Urol 125: 343

    Google Scholar 

  33. Habib HN (1967) Experience and recent contributions in sacral nerve stimulation for voiding in both man and animal. Br J Urol 39: 79

    Google Scholar 

  34. Hahn EF, Fishman J (1979) Changes in rat brain opiate receptor content upon castration and testosterone replacement. Biochem Biophys Res Commun 90: 819

    PubMed  Google Scholar 

  35. Harrison IM, Rabkin JG, Ehrhardt AA, Stewart JW, Mc Grath PJ, Ross D, Quickin FM (1986) J Clin Psychol 6: 144

    Google Scholar 

  36. Juenemann KP, Lue TF, Abozeid M, Hellstrom WJ, Tanagho EA (1986) Blood gas analysis in drug induced penile erection. Urol Int 41, 3: 207

    PubMed  Google Scholar 

  37. Juskiewenski S, Vaysse Ph, Moscovici J, Hammoudi S, Bouisson E (1982) A study of the arterial blood supply to the penis. Anat Clin 4: 101

    Google Scholar 

  38. Kanacan I, Hirshkowitz M, Salis PJ, Norter E, Safi MF (1987) Penile blood flow and muscular events during sleep-related erections of middle-aged men. J Urol 137: 177

    Google Scholar 

  39. Kokotas NS, Schmidt RA, Tanagho EA (1978) Motor innervation of the urinary tract studied by retrograde axonal transport of protein. Invest Urol 16: 179

    PubMed  Google Scholar 

  40. Kollberg S, Petersen I, Steuer I (1962) Preliminary results of an electromyographic study of ejaculation. Acta Clin Scand 123: 478

    Google Scholar 

  41. Krane RJ, Siroky MB (1981) Neuro-physiology of erection. Urol Clin N Amer 8, 1: 91

    Google Scholar 

  42. Kuntz A (1947) Autonomic nervous system. Lea and Febiger, Philadelphia

    Google Scholar 

  43. Lal S, Ackman D, Thavundayil JX, Kiely ME, Etienne P (1984) Effect of apomorphine, a dopamine receptor agonist on penile tumescence in normal subjects. Prof Neural Psychopharmacol Brit Psychiat 8: 695

    Google Scholar 

  44. Langley JN, Anderson HK (1805–1806) The innervation of the pelvic viscera and adjoining viscera. The external generative organs. J Physiol 19: 85

    Google Scholar 

  45. Latarjet A, Bonnet P (1913) Le plexus hypogastrique chez l'homme. Lyon CHir 9: 221

    Google Scholar 

  46. Lavoisier P, Courton F, Barres D, Blanchard M (1986) Correlation between intracavernous pressure and contraction of the ischio-cavemous muscle in man. J Urol 136: 936

    PubMed  Google Scholar 

  47. Lecoguic G, Buzelin JM, Leborgne J, Duveau D, Pannier M, Barbin JY (1960) Bases anatomiques de l'abord chirurgical des nerfs érecteurs. Anat Clin 2: 283

    Google Scholar 

  48. Lepor H, Gregerman M, Crosby R, Mostofi FK, Walsh PC (1985) Precise localization of the autonomic nerves from the pelvic plexus to the corpora cavernosa: a detailed anatomical study of the adult male pelvis. J Urol 133: 207

    PubMed  Google Scholar 

  49. Leriche R (1923) Des oblitérations artérielles hautes (oblitérations de la terminaison de l'aorte) comme cause des insuffisances circulatoires des membres inférieurs. Bull Mem Soc Chir 1: 2404

    Google Scholar 

  50. Leriche A (1984) Anatomo-physiologie de l'érection. Med Hyg 42: 1096

    Google Scholar 

  51. Levin RM, Wein AJ (1980) Adrenergic alpha receptors out member beta-receptors in human penile corpus cavernosum. Invest Urol 18, 3: 225

    PubMed  Google Scholar 

  52. Lin SN, Wang JM, Ma CP, Chen HI (1985) Hemodynamic study of penile erection in dogs. Eur Urol 11: 401

    PubMed  Google Scholar 

  53. Lue TF, Takamura T, Schmidt RA, Tanagho EA (1983) Potential preservation of potency after radical prostatectomy. Urol 22: 165

    PubMed  Google Scholar 

  54. Lue TF, Takamura T, Schmidt RA, Palubinskas J, Tanagho EA (1983) Hemodynamics of erection in the monkey. J Urol 130: 1237

    PubMed  Google Scholar 

  55. Lue TF, Zeineh SJ, Schmidt RA, Tanagho EA (1983) Physiology of penile erection. World J Urol 1, 4: 194

    Google Scholar 

  56. Lue TF, Zeineh SJ, Schmidt RA, Tanagho EA (1984) Neuroanatomy of penile erection: its relevance to iatrogenic impotence. J Urol 131: 273

    PubMed  Google Scholar 

  57. Mas M, Zahradnik MA, Martino V, Davidson JM (1985) Stimulation of spinal serotonergic receptors facilitates seminal emission and suppresses penile erectile reflexes. Brain Res 342, 1: 128

    PubMed  Google Scholar 

  58. Meehan JP, Goldstein AMB (1983) High pressure within corpus cavernosum in man during erection. Its probable mechanism. Urol 21, 4: 385

    PubMed  Google Scholar 

  59. Newman HF, Northup JD, Devlin J (1964) Mechanism of human penile erection. Invest Urol 1: 350

    Google Scholar 

  60. Newman HF, Northup JD (1981) The mechanism of erection. An overview. Urology 17: 399

    PubMed  Google Scholar 

  61. Newman HF, Reiss H, Northup JD (1982) Physical basis of emission, ejaculation and orgasm in the male. Urology 19: 341

    PubMed  Google Scholar 

  62. Root WS, Bard P (1947) The mediation of feline erection through sympathetic pathways with some remarks on sexual behavior after deafferentation of the genitalia. Am J Physiol 151: 80

    Google Scholar 

  63. Semans JH, Langworthy DR (1938) Observation on neurophysiology of sexual function in the male cat. J Urol 40: 836

    Google Scholar 

  64. Sjostrand NO, Klinge SMM (1979) Principal mechanisms controlling penile retraction and protrusion in rabbits. Acta Physiol Scand 106: 199

    PubMed  Google Scholar 

  65. Steers WD, Mc Connell J, Benson GS (1984) Some pharmacologic effects of yohimbine on human and rabbit penis. J Urol 131: 799

    PubMed  Google Scholar 

  66. Steers WD, Mc Connell J, Benson GS (1984) Anatomical localization and some pharmacological effects of vasoactive intestinal polypeptide in human and monkey corpus cavernosum. J Urol 132: 1048

    PubMed  Google Scholar 

  67. Tanagho EA, Schmidt RA, De Aranja CG (1982) Urinary striated sphincter. What is its nerve supply ? Urology 20: 415

    PubMed  Google Scholar 

  68. Thurofl JW, Bazerd MA, Schmidt RA, Tanagho EA (1986) Functional pattern of sacral root stimulation III erection. Eur Urol 12: 134

    PubMed  Google Scholar 

  69. Virag R, Ottesen B, Fahrenbrug J, Levy C, Wagner G (1982) Vasoactive intestinal polypeptide release during penile erection in man. Lancet 2: 1166

    Google Scholar 

  70. Virag R, Perry-Spencer P, Frydman D (1984) Artificial erection in diagnosis and treatment of impotence. Urol 24, 2: 157

    PubMed  Google Scholar 

  71. Wagner G, Willis EA, Bro-Rasmussen F, Nielsen MM (1982) New theory on the mechanism of erection involving Hilberto undescribed vessels. Lancet 416

  72. Walsh PC, Donker PJ (1982) Impotence following radical prostatectomy: insight into etiology and prevention. J Urol 128: 492

    PubMed  Google Scholar 

  73. Walsh PC, Lepor H, Eggliston JC (1983) Radical prostatectomy with preservation of sexual function: anatomical and pathological considerations. Prostate 4: 473

    PubMed  Google Scholar 

  74. Weiss HD (1972) The physiology of human penile erection. An Int Med 76: 793

    Google Scholar 

  75. Weiss JP, Schlecker BA, Wein AJ, Hanno PM (1985) Preservation of periprostatic autonomic nerves during total perineal prostatectomy by intrafascial dissection. Urol 26: 160

    PubMed  Google Scholar 

  76. Whitelaw GP, Smitthwick RH (1951) Some secondary effects of sympathectomy with particular reference to disturbance of sexual function. New Engl J Med 25: 121

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Service d'Urologie, Laboratoire d'Anatomie, Hôpital Universitaire de Bicêtre, 78, rue du Général-Leclerc, 94275, Le Kremlin Bicêtre Cedex, France

    G. Benoit, C. Gillot & A. Jardin

  2. Laboratoire d'Anatomie, Biomédicale des Saints-Pères, 45, rue des Saints-Pères, 75007, Paris, France

    V. Delmas

Authors
  1. G. Benoit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. V. Delmas
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Gillot
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A. Jardin
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Benoit, G., Delmas, V., Gillot, C. et al. The anatomy of erection. Surg Radiol Anat 9, 263–272 (1987). https://doi.org/10.1007/BF02105295

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02105295

Key words

Search

Navigation