Cavernous nerves

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Cavernous nerves of clitoris
Details
From Uterovaginal plexus
Identifiers
Latin nervi cavernosi clitoridis
Anatomical terms of neuroanatomy
Cavernous nerves of penis
Details
From Prostatic plexus
Identifiers
Latin nervi cavernosi penis
Anatomical terms of neuroanatomy

The cavernous nerves are post-ganglionic parasympathetic nerves that facilitate penile erection and clitoral erection. [1] They arise from cell bodies in the inferior hypogastric plexus where they receive the pre-ganglionic pelvic splanchnic nerves (S2-S4).

Contents

In the penis, there are both lesser cavernous nerves and a greater cavernous nerve.

Clinical considerations

These nerves are susceptible to injury following prostatectomy or genital surgery.

Nerve-sparing prostatectomy was invented for surgeons to avoid injuring the nerves and causing erectile dysfunction complications. During surgery, a doctor may apply a small electrical stimulation to the nerve and measure the erectile function with a penile plethysmograph. [2] This test aids the surgeon in identifying the nerves, which are difficult to see. [3]

Related Research Articles

<span class="mw-page-title-main">Clitoris</span> Organ at the top of the vulva

The clitoris is a female sex organ present in mammals, ostriches, and a limited number of other animals. In humans, the visible portion – the glans – is at the front junction of the labia minora, above the opening of the urethra. Unlike the penis, the male homologue (equivalent) to the clitoris, it usually does not contain the distal portion of the urethra and is therefore not used for urination. In most species, the clitoris lacks any reproductive function. While few animals urinate through the clitoris or use it reproductively, the spotted hyena, which has an especially large clitoris, urinates, mates, and gives birth via the organ. Some other mammals, such as lemurs and spider monkeys, also have a large clitoris.

Erectile dysfunction (ED), also referred to as impotence, is a form of sexual dysfunction in males characterized by the persistent or recurring inability to achieve or maintain a penile erection with sufficient rigidity and duration for satisfactory sexual activity. It is the most common sexual problem in males and can cause psychological distress due to its impact on self-image and sexual relationships.

<span class="mw-page-title-main">Priapism</span> Medical condition where an erection lasts excessively long

Priapism is a condition in which a penis remains erect for hours in the absence of stimulation or after stimulation has ended. There are three types: ischemic (low-flow), nonischemic (high-flow), and recurrent ischemic (intermittent). Most cases are ischemic. Ischemic priapism is generally painful while nonischemic priapism is not. In ischemic priapism, most of the penis is hard; however, the glans penis is not. In nonischemic priapism, the entire penis is only somewhat hard. Very rarely, clitoral priapism occurs in women.

<span class="mw-page-title-main">Penis enlargement</span> Technique aimed to increase the size of a human penis

Penis enlargement, or male enhancement, is any technique aimed to increase the size of a human penis. Some methods aim to increase total length, others the shaft's girth, and yet others the glans size. Techniques include surgery, supplements, ointments, patches, and physical methods like pumping, jelqing, and traction.

Anorgasmia is a type of sexual dysfunction in which a person cannot achieve orgasm despite adequate stimulation. Anorgasmia is far more common in females than in males and is especially rare in younger men. The problem is greater in women who are post-menopausal. In males, it is most closely associated with delayed ejaculation. Anorgasmia can often cause sexual frustration.

Erectile tissue is tissue in the body with numerous vascular spaces, or cavernous tissue, that may become engorged with blood. However, tissue that is devoid of or otherwise lacking erectile tissue may also be described as engorging with blood, often with regard to sexual arousal.

Penile plethysmography (PPG) or phallometry is a measurement of blood flow to the penis, typically used as a proxy for measurement of sexual arousal. The most commonly reported methods of conducting penile plethysmography involves the measurement of the circumference of the penis with a mercury-in-rubber or electromechanical strain gauge, or the volume of the penis with an airtight cylinder and inflatable cuff at the base of the penis. Corpora cavernosa nerve penile plethysmographs measure changes in response to inter-operative electric stimulation during surgery. The volumetric procedure was invented by Kurt Freund and is considered to be particularly sensitive at low arousal levels. The easier to use circumferential measures are more widely used, however, and more common in studies using erotic film stimuli. A corresponding device in women is the vaginal photoplethysmograph.

<span class="mw-page-title-main">Metoidioplasty</span> Surgical procedure used to create a penis from the clitoris

Metoidioplasty, metaoidioplasty, or metaidoioplasty is a female-to-male gender-affirming surgery.

<span class="mw-page-title-main">Prostatectomy</span> Surgical removal of all or part of the prostate gland

Prostatectomy is the surgical removal of all or part of the prostate gland. This operation is done for benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the pelvis.

<span class="mw-page-title-main">Ophthalmic nerve</span> Sensory nerve of the face

The ophthalmic nerve (CN V1) is a sensory nerve of the head. It is one of three divisions of the trigeminal nerve (CN V), a cranial nerve. It has three major branches which provide sensory innervation to the eye, and the skin of the upper face and anterior scalp, as well as other structures of the head.

<span class="mw-page-title-main">Radical retropubic prostatectomy</span>

Radical retropubic prostatectomy is a surgical procedure in which the prostate gland is removed through an incision in the abdomen. It is most often used to treat individuals who have early prostate cancer. Radical retropubic prostatectomy can be performed under general, spinal, or epidural anesthesia and requires blood transfusion less than one-fifth of the time. Radical retropubic prostatectomy is associated with complications such as urinary incontinence and impotence, but these outcomes are related to a combination of individual patient anatomy, surgical technique, and the experience and skill of the surgeon.

<span class="mw-page-title-main">Prostatic plexus (nervous)</span>

The prostatic plexus is continued from the lower part of the pelvic plexus. It lies within the fascial shell of the prostate.

Nocturnal penile tumescence (NPT) is a spontaneous erection of the penis during sleep or when waking up. Along with nocturnal clitoral tumescence, it is also known as sleep-related erection. Men without physiological erectile dysfunction or severe depression experience nocturnal penile tumescence, usually three to five times during a period of sleep, typically during rapid eye movement sleep. Nocturnal penile tumescence is believed to contribute to penile health.

<span class="mw-page-title-main">Penile implant</span> Medical device

A penile implant is an implanted device intended for the treatment of erectile dysfunction, Peyronie's disease, ischemic priapism, deformity and any traumatic injury of the penis, and for phalloplasty or metoidioplasty, including in gender-affirming surgery. Men also opt for penile implants for aesthetic purposes. Men's satisfaction and sexual function is influenced by discomfort over genital size which leads to seek surgical and non-surgical solutions for penis alteration. Although there are many distinct types of implants, most fall into one of two categories: malleable and inflatable transplants.

A neurovascular bundle is a structure that binds nerves and veins with connective tissue so that they travel in tandem through the body.

<span class="mw-page-title-main">Human penis</span> Human male external reproductive organ

In human anatomy, the penis is an external male sex organ that additionally serves as the urinary duct. The main parts are the root, body, the epithelium of the penis including the shaft skin, and the foreskin covering the glans. The body of the penis is made up of three columns of tissue: two corpora cavernosa on the dorsal side and corpus spongiosum between them on the ventral side. The human male urethra passes through the prostate gland, where it is joined by the ejaculatory duct, and then through the penis. The urethra traverses the corpus spongiosum, and its opening, the meatus, lies on the tip of the glans. It is a passage both for urination and ejaculation of semen.

Nerve-sparing surgery is a type of surgery that attempts to save the nerves near the tissues being removed.

<span class="mw-page-title-main">Erection</span> Physiological phenomenon involving the hardening and enlargement of the penis

An erection is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, and endocrine factors, and is often associated with sexual arousal, sexual attraction or libido, although erections can also be spontaneous. The shape, angle, and direction of an erection vary considerably between humans.

<span class="mw-page-title-main">Clitoral erection</span> Physiological phenomenon involving the engorgement of the clitoris

Clitoral erection is a physiological phenomenon where the clitoris becomes enlarged and firm.

Anthony James Costello, FRACS, FRCSI, is an Australian urologist. He served as head of the department of urology at the Royal Melbourne Hospital, Australia. He established the first robotic prostate cancer surgery programme in Australia and published the first series of men who had laser surgery for benign prostate enlargements.

References

  1. Oakley, Susan H.; Mutema, George K.; Crisp, Catrina C.; Estanol, M. Victoria; Kleeman, Steven D.; Fellner, Angela N.; Pauls, Rachel N. (September 2013). "Innervation and histology of the clitoral-urethal complex: a cross-sectional cadaver study". The Journal of Sexual Medicine. 10 (9): 2211–2218. doi:10.1111/jsm.12230. ISSN   1743-6109. PMID   23809460.
  2. Dr. Peter Scardino's Prostate Book, Avery, 2005
  3. Blue Torch December 2007