Macro-microscopic examination of the valves of the deep dorsal vein of the human penis

Abstract

BACKGROUND: The study of the structure of the deep dorsal vein of the human penis has a long history but, so far, data on the presence of valves in it are contradictory. Contradictions and ambiguities in the functioning of the valvular apparatus of the deep dorsal vein, lack of information on the morphological structure of its valves, and the importance of the venous system in the physiology of erection motivated this study.

AIM: To study the valves of the deep dorsal vein of the human penis.

MATERIALS AND METHODS: The study of deep dorsal vein valves in 150 men was carried out, using macroscopic and microscopic methods, on autopsy material. Forty-seven trunks of the deep dorsal vein isolated using magnifying optics ×3.5 from the coronal sulcus to the prostatic venous plexus and 103 fragments of the vein in cross section directly distal to the supporting ligament were studied. We used histological painting coloring with hematoxylin-eosin, funcionam with fuchsin, and Mallory. The obtained images of valves in longitudinal and cross sections were subjected to photo-registration and archiving for further study and analysis.

RESULTS: Generally, the studied vein had one trunk, but in 7.3% of cases it had two trunks. Most often there was a division of the main trunk of the vein. Valves of the deep dorsal vein in the longitudinal section were detected in 89% of observations. On the cross section, the valve in 36% of cases was detected near the supporting ligament. Valves are represented most often by two flaps, at the base of which was a roller associated with the middle shell of the vein wall. The valves of the deep dorsal vein of the penis had the typical appearance of pocket type valves and did not prevent the outflow of venous blood from the cavernous bodies, blocking retrograde blood flow.

CONCLUSIONS: Valves are an integral component of the deep dorsal vein of the human penis. The structure of the valves indicates that they prevent retrograde blood flow to the cavernous bodies, both at rest and during erection.

Keywords

deep dorsal vein / penis / men / valves / morphological study

References

[1] Herwig R, Kamel A, Shabsigh R. Erectile dysfunction and cavernous veno-occlusive disease. J Mens Health. 2019;15(2):12–19. doi: 10.22374/jomh.v15i2.67

[2] Herwig R., Kamel A., Shabsigh R. Erectile dysfunction and cavernous veno-occlusive disease // J Mens Health. 2019. Vol. 15, N 2. P. 12–19. doi: 10.22374/jomh.v15i2.67

[3] Hsu GL, Hung YP, Tsai MH, et al. The venous drainage of the corpora cavernosa in the human penis. Arab J Urol. 2013;11(4):384–391. doi: 10.1016/j.aju.2013.04.002

[4] Hsu G.L., Hung Y.P., Tsai M.H., et al. The venous drainage of the corpora cavernosa in the human penis // Arab J Urol. 2013. Vol. 11, N 4. P. 384–391. doi: 10.1016/j.aju.2013.04.002

[5] Hsieh CH, Liu SP, Hsu GL, et al. Advances in understanding of mammalian penile evolution, human penile anatomy and human erection physiology: clinical implications for physicians and surgeons. Med Sci Monit. 2012;18(7):RA118–125. doi: 10.12659/msm.883201

[6] Hsieh C.H., Liu S.P., Hsu G.L., et al. Advances in understanding of mammalian penile evolution, human penile anatomy and human erection physiology: clinical implications for physicians and surgeons // Med Sci Monit. 2012. Vol. 18, N 7. P. RA118–125. doi: 10.12659/msm.883201

[7] Gaivoronskiу IV, Goryacheva IA, Matvienko YuA, et al. Penis. Anatomy of erectile dysfunction Saint Petersburg: SpetsLit; 2018. 191p. (In Russ).

[8] Гайворонский И.В., Горячева И.А., Матвиенко Ю.А., и др. Половой член. Анатомия эректильной дисфункции. Санкт-Петербург: СпецЛит, 2018. 191 с.

[9] Sadovnikov VI, Filippov VV, Sandrikov VA, et al. Venous system of penis. Pirogov Russian Journal of Surgery. 2005;(9):63–68. (In Russ).

[10] Садовников В.И., Филиппов В.В., Сандриков В.А., и др. Венозная система полового члена // Хирургия. Журнал им. Н.И. Пирогова. 2005. № 9. С. 63–68.

[11] Kurbatov DG (editor). Diagnostic and treatment venogenic erectile dysfunction: clinical handbook. Moscow: Medpraktika-M; 2017. 256 p. (In Russ).

[12] Диагностика и лечение веногенной эректильной дисфункции: клиническое руководство / под ред. Д.Г. Курбатова. Москва: Медпрактика-М, 2017. 256 с.

[13] Hallerstrom M, von Stempel CB, Raheem A, Walkden M. Abnormal deep dorsal vein resulting in veno-occlusive erectile dysfunction. BMJ Case Rep. 2018:bcr2017223496. doi: 10.1136/bcr-2017-223496

[14] Hallerstrom M., von Stempel C.B., Raheem A., Walkden M. Abnormal deep dorsal vein resulting in veno-occlusive erectile dysfunction // BMJ Case Rep. 2018. P. bcr2017223496. doi: 10.1136/bcr-2017-223496

[15] Lee D, Rotem E, Lewis R, et al. Bilateral external and internal pudendal veins embolization treatment for venogenic erectile dysfunction. Radiol Case Rep. 2016;12(1):92–96. doi: 10.1016/j.radcr.2016.11.002

[16] Lee D., Rotem E., Lewis R., et al. Bilateral external and internal pudendal veins embolization treatment for venogenic erectile dysfunction // Radiol Case Rep. 2016. Vol. 12, N 1. P. 92–96. doi: 10.1016/j.radcr.2016.11.002

[17] Okolokulak ES, Volchkevich DA. Constitutional variability of blood vessels of the penis of man. Journal of Grodno State Medical University. 2013;(2):38–41. (In Russ).

[18] Околокулак Е.С., Волчкевич Д.А. Конституциональная изменчивость сосудов полового члена человека // Журнал Гродненского государственного медицинского университета. 2003. № 2. С. 38–41.

[19] Trushkov PV. Treatise on the human venous valve. Kirov: Kirov Regional Printing House; 2006. 120 p. (In Russ).

[20] Трушков П.В. Трактат о венозном клапане человека. Киров: Кировская областная типография, 2006. 120 с.

[21] Casey WC, Woods RW. Anatomy and histology of penile deep dorsal vein: venous cushions and proximal “sphincter”. Urology. 1982;19(3):284–286. doi: 10.1016/0090-4295(82)90500-3

[22] Casey W.C., Woods R.W. Anatomy and histology of penile deep dorsal vein: venous cushions and proximal "sphincter" // Urology. 1982. Vol. 19, N 3. P. 284–286. doi: 10.1016/0090-4295(82)90500-3

[23] Strelkov AN, Ulitenko AI. Agerelated dynamics of elasticity of deep dorsal vein of human penis according to results of direct measurements. I.P. Pavlov Russian Medical Biological Herald. 2018;26(2):238–244. doi: 10.23888/PAVLOVJ2018262238-244

[24] Стрелков А.Н., Улитенко А.И. Возрастная динамика упругости глубокой дорсальной вены полового члена человека по данным прямых измерений // Российский медико-биологический вестник им. академика И.П. Павлова. 2018. Т. 26, № 2. С. 238–244. doi: 10.23888/PAVLOVJ2018262238-244

RIGHTS & PERMISSIONS

Eco-Vector