The vasculature of the human penis: a reexamination of the morphological basis for the polster theory of erection.

The morphology of human penile blood vessels has been studied to characterize columns of smooth muscle found in the intima. Although previous workers (Kiss, 1921; Conti, 1952) termed these intimal pads or polsters and concluded that they were actively responsible for the production of erection, more recent work has questioned these conclusions (Benson et al., 1980; Newman and Tchertkoff, 1980). Serial sections were taken throughout the length of the penis from 11 cadavers and stained with various histopathological stains. Numerous polster-like structures were found, but all could be identified as either branch points in vessels, intimal cushions located at branch points, or arteriosclerotic lesions at various stages of development. None of these structures seem capable of functioning in the manner attributed to them by Conti (1952) and others. Furthermore, comparison of the structures found in the present study to illustrations of polsters in Conti's paper suggest that these are identical. The present study refutes the polster theory of erection and leaves open to further question the mechanisms involved in the control of blood flow into and within the penis.