人类阴茎纤维血管组件需要十条纤维韧带的完整性。

The Human Penile Fibro-Vascular Assembly Requires the Integrity of Ten Fibro-Ligaments.

作者信息

Chen Heng-Shuen, Fang Chu-Wen, Tsai Raymond W M, Hsu Chih-Yuan, Hsu Geng-Long, Lu Hsiu-Chen, Tsai Mang-Hung, Chueh Jeff S C

机构信息

Microsurgical Potency Reconstruction and Research Center, Puli Christian Hospital, No. 1, Tieshan Rd., Puli, Nantou 54546, Taiwan.

Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 100225, Taiwan.

出版信息

Life (Basel). 2025 Sep 22;15(9):1492. doi: 10.3390/life15091492.

DOI:10.3390/life15091492

PMID:41010434

Abstract

INTRODUCTION

Penile fibro-ligaments have been extensively studied for many centuries; however, there is, unfortunately, a lack of thorough understanding. We aimed to bridge the research gap between anatomy and surgical reconstruction.

METHODS

We excluded cadaveric penises, already dissected and disassembled by medical students, that had damaged the corpora cavernosa (CC) or corpus spongiosum (CS). However, penises were included if both the ischiocavernosus and bulbospongiosus muscles were undamaged. A total of 8 out of 52 penises were meticulously examined. Our dissection findings were supplemented with 101 cadaveric photos, 255 penile vascular surgeries, 11 CT imaging scans, and 8 MRI imaging scans. The combined understanding was reprocessed with radiographic imaging, and patients underwent penile surgeries, notably eight hypospadias surgeries, and eight penile elongation surgeries were performed elsewhere.

RESULTS

Bilaterally, the penile CC is primarily anchored to the pelvic wall through the cavernosal ligament (CL = 2), while the CS is connected to the urinary sphincter. The suspensory, fundiform, and arcuate pubic ligament (two anatomically and one functionally) assist in stabilizing and holding the penile shaft to the pelvic wall. Distally, a distal ligament (DL = 1) and spongiosal ligament (SL = 1) extend the CC and CS to the glans penis and frenulum, ensuring urethral patency when necessary. The CC is encircled by a bi-layered tunica consisting of a 360° inner circular and a 300° outer longitudinal tunica. The ischiocavernosus muscle wraps around the penile crus and envelops the CL, connecting to the ischial tuberosity. The CS is partially surrounded by the bulbospongiosus muscle proximally and receives the SL distally. The entire penis interconnects with the skeletal muscle of the urogenital diaphragm.

CONCLUSION

The physiological integrity of the human penis relies on ten anatomically and six functionally fibro-muscular ligaments.

摘要

引言

阴茎纤维韧带已经被广泛研究了许多世纪；然而，遗憾的是，人们对此缺乏深入的了解。我们旨在弥合解剖学与手术重建之间的研究差距。

方法

我们排除了已被医学生解剖和拆解、损伤了海绵体（CC）或尿道海绵体（CS）的尸体阴茎。然而，如果坐骨海绵体肌和球海绵体肌均未受损，则纳入该阴茎。在52个阴茎中，共对8个进行了细致检查。我们的解剖结果辅以101张尸体照片、255例阴茎血管手术、11例CT成像扫描和8例MRI成像扫描。通过影像学成像对综合理解进行再处理，并且患者接受了阴茎手术，特别是8例尿道下裂手术，另外在其他地方进行了8例阴茎延长手术。

结果

双侧阴茎海绵体主要通过海绵体韧带（CL = 2）固定于盆腔壁，而尿道海绵体与尿道括约肌相连。悬韧带、耻骨前襞和耻骨弓状韧带（两个解剖学的和一个功能性的）有助于将阴茎体稳定并固定于盆腔壁。在远端，一条远端韧带（DL = 1）和海绵体韧带（SL = 1）将阴茎海绵体和尿道海绵体延伸至阴茎头和系带，在必要时确保尿道通畅。阴茎海绵体被一层双层膜包裹，该膜由360°的内层环形膜和300°的外层纵行膜组成。坐骨海绵体肌环绕阴茎脚并包绕海绵体韧带，与坐骨结节相连。尿道海绵体近端部分被球海绵体肌包围，远端接受海绵体韧带。整个阴茎与尿生殖膈的骨骼肌相互连接。