Glans Penis

Glans Penis

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Synonyms:
Arteria pudendalis interna

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Author:
Jana Vasković MD
•

Reviewer:
Roberto Grujičić MD

Last reviewed: July 06, 2022

Reading time: 14 minutes

Honored everywhere from ancient statues and Renaissance paintings to modern-day graffiti, the human genitalia may be the most memorable human organs on the planet. However, there’s no piece of phallic art that can describe the penis as scientifically accurate as human anatomy can.

The penis is a copulatory organ of the external genitalia of the males . It consists of three parts ; root (radix), body (shaft) and glans. The core of the penis contains three erectile tissues, namely the two corpora cavernosa and the corpus spongiosum. Furthermore, the penis transmits the penile neurovascular bundle, as well as the terminal part of the urethra , which opens at its tip. Therefore, the penis is a meeting point between the urinary and reproductive systems , and its functions are defined within the spectrum of functions of these two systems;

This article will discuss the anatomy and functions of the penis.

The root of the penis is the most proximal part of the penis. It is located in the urogenital triangle of the perineum , where it is fixed to the pubic symphysis via the two suspensory ligaments of the penis. The root consists of the two muscles (ischiocavernosus and bulbospongiosus muscles) and proximal expansions of the erectile tissues; the two crura of penis and the bulb of penis.
The crura of penis are the proximal projections of the corpora cavernosa. The crura diverge laterally, with each crus attaching to the ipsilateral ischiopubic ramus.
The bulb of penis is a proximal expansion of the corpus spongiosum. It is located in the interval between the crura of penis, and is proximally continued by the bulbospongiosus muscle . The bulb is pierced by the penile urethra, which after passing through the bulb, continues through the entire length of the corpus spongiosum until reaching the tip of the glans.
The body of penis is the free pendulous part entirely enveloped in skin . Deep to the skin, there are three fasciae that envelop the contents of the penis. From superficial to deep, they are the superficial fascia of penis (dartos fascia of penis), deep fascia of penis (Buck’s fascia) and tunica albuginea.
The shaft of the penis contains three erectile tissues ; the two corpora cavernosa and the corpus spongiosum. These tissues extend through the entire body of penis. The corpora cavernosa lie one next to another in the dorsal compartment of the penis, while the corpus spongiosum lies in the ventral groove between them. In addition, the body of penis transmits the urethra and the penile neurovasculature.
The corpora cavernosa are the two erectile masses found within the dorsal part of the penis. Each begins within the root of penis as the crus of penis, traverses the shaft and terminates within the glans.
The corpora cavernosa are enveloped by the tunica albuginea , which is a layer of dense fibroelastic connective tissue . The tunica albuginea consists of an inner (circular) and an outer (longitudinal) fascial layer. Each corpus cavernosum is wrapped by its own circular layer, while a single longitudinal layer encloses them both. The circular layers form an incomplete fibrous septum between the adjoining sides of the corpora cavernosa. The ventral groove between the corpora cavernosa is occupied by the corpus spongiosum. The dorsal groove is traversed by the neurovascular bundle of penis which consists of the dorsal arteries of penis, dorsal veins of penis and the dorsal nerves of penis.
The corpora cavernosa contain a network of interconnected irregularly shaped sinusoid vascular spaces lined with endothelial cells. These sinusoid spaces are separated by the septae that pass from the tunica albuginea. The septae consist of the fibrous connective tissue rich with numerous smooth muscle cells .
Once filled with arterial blood from the helicine arteries, the cavernous sinuses compress the venous drainage from the penis, which manifests as the penile erection. The fibrous septum between the corpora cavernosa is incomplete proximally, allowing the blood exchange between the cavernous sinuses of the corpora.
The corpus spongiosum is a spongy mass of the erectile tissue found within the ventral compartment of the penis. It has a proximal dilation that projects into the root of penis, i.e. the bulb of penis. The corpus spongiosum features a distal bulbous expansion at the end of the penile shaft as well, which forms the glans penis . The glans shows a rounded base called the corona which demarcates it from the penile shaft. The glans is covered by the foreskin (prepuce), which is a double layer of loose retractable skin that attaches to the ventral surface of glans. The attaching site of the deep layer of the foreskin to the urethral surface lies under the corona and is called the frenulum .
The corpus spongiosum is enveloped by a thin layer of tunica albuginea and contains less erectile tissue than the corpora cavernosa. It is traversed by the penile urethra , which opens at the tip of the glans. The corona of glans contains many small preputial glands that secrete the sebaceous product called the smegma .
The penis is supplied by the internal pudendal artery , a branch of the internal iliac artery . This artery enters the penis via Alcock’s canal after which it divides into the perineal and common penile arteries. The former supplies the ischiocavernosus and bulbospongiosus muscles, while the common penile artery divides into three branches to supply the deep structures of the penis. These branches are the:
The venous drainage of the penis happens via one of the three systems;
The sensory innervation to the penis comes from a terminal branch of the pudendal nerve ; the dorsal nerve of penis . This nerve traverses the dorsal groove between the corpora cavernosa together with the same-named artery and vein. Along its course, it gives off many sensory branches that supply the skin of the penile shaft, as well as the prepuce of glans. The glans receives most of the sensory nerve endings, which is why it is the most sensitive area of the penis. The root of the penis receives the sensory innervation from the branches of the ilioinguinal nerve .
The autonomic innervation for the penis, both sympathetic and parasympathetic , comes from the pelvic plexus via the cavernous (deep/cavernosal) nerve .
Erection and ejaculaton are regulated by the autonomic innervation of the penis. The parasympathetic stimulation is excitatory for the penis, as it causes the erection . The parasympathetic stimuli relax the smooth musculature of the corpora cavernosa and produce vasodilation in the helicine arteries. The helicine arteries then fill the corpora cavernosa, compressing the venous outflow from the penis. This process is called the veno-occlusive mechanism and it results with penile erection.
On the other hand, the inhibitory sympathetic stimuli cause the ejaculation when the critical level of sexual excitement has been reached. The ejaculation process can be divided into two phases. In the first phase, the sympathetic stimuli cause the vasoconstriction of helicine arteries, contraction of the smooth muscle cells within the septa of corpus spongiosum and contraction seminal vesicles and prostate . This results in accumulation of seminal fluid into the proximal part of the urethra. During the second phase, the bulbospongiosus muscle contracts and expels the seminal fluid through the urethra ( ejaculation ). When the ejaculation is finished the penis returns into the flaccid state. An individual normally produces 3-5 ml of semen per one ejaculation which contains about 300 million sperm cells.
Learn more about the anatomy and function of the male reproductive system with our articles, video tutorials, quizzes and labeled diagrams.
Phimosis is a condition in which a person has difficulties to retract the prepuce (foreskin). It is recognized as a ring of foreskin around the tip of the glans. Phimosis is classified as physiological and pathological.
The treatment of pathological phimosis depends on its severity and conjoined complications. Usually there are three therapeutic approaches; smooth and gentle manual daily retraction, application of topical corticosteroids, or surgical circumcision.
Paraphimosis is a condition in which the retracted prepuce cannot be put back in its normal position. This often causes the swelling of the foreskin that can lead to the blockage of the blood flow in the glans. If not urgently treated this condition can lead to serious complications.Once surgically resolved, it does not require any further treatment.
Recurring paraphimosis is rare and it is an indication for circumcision.

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A copulatory organ of the external genitalia of males whose function is to enable the reproduction, sexual pleasure and micturition

Corpora cavernosa, corpus spongiosum, urethra

Bulbourethral artery, dorsal artery of penis, cavernous (deep/cavernosal) artery of penis;
Superficial dorsal, deep dorsal, circumflex, crural, and cavernous (deep/cavernosal) veins of penis

Sensory: Pudendal nerve (via dorsal nerve of penis)
Autonomic: Cavernous (deep/cavernosal) nerve of penis

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The penis is the main component of the genitourinary tract of males, as it ensures a wide range of vital physiological functions, including erections, ejaculation, and micturition.
This organ has a complex anatomy that allows it to perform different functions, such as size variation between the state of erection and flaccidness.
In this article we will comprehensively cover the anatomy of the penis and see how each structure offers different physiological functions
The penile shaft has 3 erectile columns (2 corpora cavernosa and one corpus spongiosum), blood vessels, nerve endings, and lymphatic circulation. ( 1 )
All of these structures are covered by the skin.
An erection is mediated by the corpora cavernosa that contains erectile tissue, as well as a few elastic fibers found in the tunica albuginea.
In the upcoming sections, we will detail each component of the penile tissue.
The penis glans is a cap expansion of the corpus spongiosum that’s molded on the distal ends of the corpora cavernosa.
The glans will then extend on the upper and lower surfaces of the corpora cavernosa. The term glans was derived from the Latin word for ‘acorn’, which means a smooth oval nut.
In the central end of the glans, there is an opening of the urethra that allows semen and urine to exit the body, which is referred to as the meatus.
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At birth, the glans of the penis will be attached to the foreskin, which will separate from the glans until the skin becomes fully retractile.
This process is long and can take up to 18 years to fully separate.
In circumcised children, the majority of the foreskin is removed, leaving the glans exposed and increases the risk of some infections at the meatus (urethra opening) level.
However, uncircumcised children are also prone to bacterial overgrowth, hence the need for daily cleaning of the glans and meatus. ( 2 )
The spongy part of the urethra forms during the tubularization phase (embryological phase) under the influence of dihydrotestosterone.
For the anatomy of the urethra, it originates from the bladder neck and ends at the meatus on the glans penis.
The length of the urethra varies between males but it ranges between 15-25 cm with an “S” curved shape when viewed from the sides.
Anatomists divide the urethra into 3 segments:
As the name implies, this segment of the urethra goes through the prostate after originating from the bladder neck to finally end at the membranous urethra.
The prostatic urethra is supported superiority by the bladder and inferiority by the perineal membrane and the sphincter urethrae externus muscle. ( 3 )
It traverses the prostate in an area that’s prone to benign prostatic hyperplasia (BPH), which compresses the prostatic urethra and causes all the signs and symptoms associated with BPH.
As for the posterior side of the prostatic urethra, it houses the urethral crest that’s laterally limited by the prostatic sinuses to drain the surrounding glands.
This crest contains the seminal colliculus, or verumontanum, which is the area where the ejaculatory ducts and the opening of the prostatic utricle meet.
Relative to the other segments, the membranous urethra is the shortest, spanning from the apex of the prostate to the bulb of the penis. The membranous urethra is invested in the perineal membrane, as well as the external urethral sphincter.
This portion of the urethra was given this name because it runs along the corpus spongiosum.
Typically, experts divide this portion into:
The vascular supply of the urethra is somewhat complex, with the prostatic urethra being supplied by the inferior vesical artery that branches to penetrate the prostate and the bladder.
The membranous and the bulbar urethra are supplied by the bulbourethral artery , whereas the pendulous urethra gets its vascularization from the deep penile artery .
Generally speaking, the veins mirror the arteries in draining different portions of the urethra.
As for the lymphatic drainage, the penile urethra drains to the deep and superficial inguinal nodes.
The corpus cavernosum contains the spongy erectile tissue that mediates an erection.
Each corpus cavernosum has an artery running along its middle axis that’s properly named the cavernosal artery, which initiates erections when blood flow runs through.
There are muscles that support the dynamic changes of corpus cavernosum and the penis during erection and ejaculation.
The relaxation of these muscles will send signals to the brain to start the process of an erection by pumping blood inside the corpora cavernosa, creating a pressure that expands the penile tissue and blocks the drainage of blood of the veins.
Once the muscles contract again, blood flow will moving through the penis, and the veins restore their function.
The corpus spongiosum is a mass of erectile tissue that’s located under the corpus cavernosa. This entity contains approximately 90% of the blood volume that’s redirected to the penis during physiological erection.
As you can see in the figure above, the corpus spongiosum houses the urethra and extends to form the glans penis.
As we mentioned earlier, the spongy tissue of the penis can expand when blood rushes into the penile arteries, leading to an erection.
As the expansion occurs, the veins will be blocked to prevent blood drainage, thus maintaining the erection.
The process of tissue expansion creates a gradient between systematic blood pressure and penile pressure, where the latter exceeds the pressure of the former, blocking arterial flow to the penis.
This physiology is what allows the penis to get erect and is mediated by the parasympathetic nervous system and a crucial molecule known as nitric oxide (NO), which promotes the relaxation of smooth muscles found in the vessels of the penis to allow for blood flow. ( 4 )
In some cases, this entire process can get disrupted, leading to a classic condition referred to as erectile dysfunction (ED).
Erectile dysfunction, or ED, is a common medical condition that results in an inability to get or maintain a penile erection for the duration of sexual intercourse.
According to the American Journal of Medicine, ED affects more than 18 million Americans, which translates to approximately 18.4% of the male population.
Unfortunately, there are several causes that may lead to ED. This complicates the diagnostic and therapeutic approaches.
Numerous conditions can lead to ED, including vascular problems, neurological abnormalities, and psychological stress.
Pathophysiology of Erectile Dysfunction
Regardless of the many medical conditions that may lead to erectile dysfunction, the final result is usually the same. All patients deal with the interruption of normal blood flow through the penile arteries.
Consequently, they can no longer get and/or maintain an erection.
ED results from the disruption of one or more of the following components:
Unfortunately, each of these mechanisms is different, hence the need for various therapeutic approaches.
The penis is a fascinating piece of architecture that houses complex structures to maintain its anatomical integrity and ensure its vital physiological roles.
This article covered the basic concepts of penile anatomy without addressing some complicated topics, such as the embryological origins of different tissues or the neuroendocrine physiology that facilitates erection and ejaculation.
However, we hope this overview helped you appreciate the structural complexity of the penis and how each component plays a crucial role in the physiology of the male reproductive system.
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