人類陰莖結構的八條韌帶

許耕榕^1,2,3、張宏江³、蔡孟宏⁴、方楚文¹、許智源¹

栩仕診所^1,2,4書田泌尿眼科診所²、台大醫院³、中國醫藥大學⁴

The eight fibro-ligament structure in the human penis

Geng-Long Hsu^1,2,3, Hong-Chiang Chang³, Mang-Hung Tsai⁴, Chu-Wen Fang¹, Chi-Yuan Hsu¹

¹ Microsurgical Potency Reconstruction and Research Center, Hsu’s Andrology, Shu-Tien Urology Ophthalmology Clinic and Chung Shan Hospital², Taipei, Taiwan

³ Department of Urology, National Taiwan University hospital, Taipei, Taiwan

⁴ Department of Anatomy, China Medical University, Taichung, Taiwan

ABSTRACT

Purpose:

Given the human penis has present form for three thousand centuries and penile anatomy has been conducted for many centuries, current illustration remains a duplicate sketched in medieval times. Should this version be too ascertained to be advanced if the version fails to explain many physiological phenomena such as rhythmic ejaculation with glans nodding and ejaculation patency against the vaginal contraction during coitus etc? We sought to study the penile ligament structures which build up the integrity.

Materials and Methods:

In male human cadaveric penises, already disassembled dissected by medical students, are included if a unilateral side of the corpora cavernosa is intact enclosing the Colle’s fascia. Cadavers are excluded if both sides of corpora cavernosa are ruined even bi-layered TA model appearance. Consequently, 23 out of 41 penises were further explored. In addition to regular cadaveric dissection instruments used by medical students, surgery scalpel, dissecting microscope, scissors, etc, some more delicate facilities are used including loupe (PEAK HEAD LUPE, PEAK2035), smaller hemostatic forceps (World Precision Instrument, Germany), etc as necessary. Either Baking powder or normal saline is used to expand the tissue layers for the purpose of facilitating layer separation and identification. Furthermore, it is confirmed with 101, 11, 8, and 5 sets of dual cavernosograpy, spongiosography, CT penile imaging/cavernosography and MRI penile imaging/cavernosography respectively.

Results:

On the human penis, it is an independently functional fibro-muscular apparatus from that of the body trunk in the entire human body. In addition to the fundiform and suspensory ligament, The fibro-muscular components can be categorized into skeletal muscle type and smooth muscle type. The skeletal type includes bilateral cavernosal ligament anchoring the penis to the pelvic wall at the ischial tuberosity respectively, bilateral ischiocavernosus encircling the penile crus respectively, outer tunica albuginea, one distal ligament in the glans penis, bulbospongiosus encircling the corpus spongiosum and forming the ventral thickening of the outer tunica albuginea at the 5 and 7 Oclock positions respectively, and a spongiosal ligament that connects the corpus spongiosum to the frenulum. Proximally the entire penis intertwines with the skeletal muscle of the urogenital diaphragm. The smooth component includes the penile artery, venous structure, intracavernosal pillars, and specifically characteristic sinusoids distributed in the glans penis, corpus spongiosum, and corpora cavernosa respectively independently. In general skeletal component, making the chamber, encase the smooth component which also acts as both blood supply and drainage conducts respectively. Overall there are bilateral suspensory, fundiform, cavernosal ligaments proximally and single distal and spongiosal ligament for buttering the glans penis and securing metal patency as required. 

Conclusion:

A penile fibro-muscular assembly is an independent unit that is the exclusive milieu in providing cotton soft to a bony rigid environment in the entire human body. Overall 8 ligaments can be identified in the entire human penis.