A man presented with a non-painful semierection of two weeks duration. Two weeks earlier he woke up at night with a full erection. On his way to the bathroom, he ran into a door. At impact he felt pain in his penis and almost immediate loss of erection. Since that time, his penis was semirigid and he was unable to achieve full erection. There was no hematoma or tenderness and the penis was normal apart from semirigidity. A blood sample from the cavernoum body showed a pH of 7.31. Preliminary diagnosis was high-flow priapism due to central artery rupture. Ultrasound was performed. A transverse view of the normal distal cavernous bodies is shown.
The penile arteries arise from the internal pudendal arteries at the posterior border of the perineal diaphragm. They penetrate the diaphragm and divide into bulbocavernous branches, deep (cavernous) branches, and dorsal arteries. The cavernous arteries penetrate the corpora cavernosa and run in a central position. Venous drainage is via venae comitantes, and a single deep dorsal vein which drains into the deep prostatic complex. All the above vessels lie within the deep (Buck's) penile fascia. A superficial vein lies outside the deep fascia, and drains into the superficial external pudendal veins.
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