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The dorsal nerve of the penis has branching fibers that course laterally and transect the corpus spongiosum to the sinusoidal erectile tissue containing the urethra. The fibers of the dorsal nerve of the penis penetrate the corpus spongiosum to innervate the urethral lumen as afferents. These fibers receive input and relay the information during micturition and ejaculation. Semen is primarily expelled from the bulbous urethra via contraction of the bulbospongiosus muscle.[6] However, this muscle is not innervated by the dorsal nerve of the penis but by a sister branch of the pudendal nerve. Electrophysiological studies have documented that stimulation of the penis' dorsal nerve causes a reflex contraction of the bulbospongiosus muscle. During ejaculation, the penis dorsal nerve fibers provide the urethral sensation associated with the passage of seminal fluid necessary to sustain bulbospongiosus contractions until the expulsion of seminal fluid is complete.[7]
A neurovascular bundle runs along the dorsal aspect of the penis in a groove between the corpora cavernosa hemispheres. This groove includes the dorsal nerve of the penis, dorsal penile vein, and dorsal penile artery. These lay beneath the deep fascia, also known as Buck's fascia.
The initial cluster consists of fibers parallel to the shaft of the penis that moves distally and ends at the glans of the penis. An additional group of fibers branches from the main body towards the lateral aspects of the penis.[9] These branches vary in position and quantity. However, they always branch laterally away from the main body of the penis. The axons do not cross the dorsal midline. The gauge of the nerve bundles varies greatly, but they consistently narrow as branching continues distally.[4]
The dorsal nerve bundles continue straight into the glans penis to form midline branches, and ventrolateral branches arise from the lateral bundles. The distal branches of the terminating nerves travel toward the meatus of the urethra.[10] As the dorsal nerve of the penis enters the glans, it immediately branches and displays a more three-dimensional pattern as opposed to a linear convention seen proximally. Each of the main glandular branches continues along the tunical surface, projecting bundles of smaller nerves that extend into the tissue of the glans and outwards toward the surface of the penis.
The number of dorsal bundles most commonly reported are two and three, but there have been periodic reports of up to 8 variants. Most of the dorsal nerves run parallel to each other in the dorsal aspect of the penis, traveling distally. Communicating branches are commonly viewed in no specific orientation or frequency. These branches usually communicate amongst each other, but ventral nerve communications are noted in cadaver studies infrequently. Most dissection studies comment on the absence of nerves that cross the dorsal midline.
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