Cavernous Nerves
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Cavernous Nerves
The cavernous nerves are post-ganglionic parasympathetic nerves that facilitate penile erection and clitoral erection. They arise from cell bodies in the inferior hypogastric plexus where they receive the pre-ganglionic pelvic splanchnic nerves (S2-S4). In the penis, there are both lesser cavernous nerves and a greater cavernous nerve. Clinical considerations These nerves are susceptible to injury following prostatectomy or genital surgery. Nerve-Sparing prostatectomy was invented for surgeons to avoid injuring the nerves and causing erectile dysfunction complications. During surgery, a doctor may apply a small electrical stimulation to the nerve and measure the erectile function with a penile plethysmograph Penile plethysmography (PPG) or phallometry is measurement of blood flow to the penis, typically used as a proxy for measurement of sexual arousal. The most commonly reported methods of conducting penile plethysmography involve the measurement of .... This test ...
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Uterovaginal Plexus (nerves)
The Uterovaginal plexus is a division of the inferior hypogastric plexus. In older texts, it is referred to as two structures, the "vaginal plexus" and "uterine plexus". * The ''Vaginal Plexus'' arises from the lower part of the pelvic plexus. It is distributed to the walls of the vagina, to the erectile tissue of the vestibule, and to the cavernous nerves of the clitoris. The nerves composing this plexus contain, like the vesical, a large proportion of spinal nerve fibers. * The ''Uterine Plexus'' accompanies the uterine artery to the side of the uterus, between the layers of the broad ligament; it communicates with the ovarian plexus The ovarian plexus arises from the renal plexus, and is distributed to the ovary, and fundus of the uterus. It is carried in the suspensory ligament of the ovary.
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Prostatic Plexus (nervous)
The Prostatic Plexus is continued from the lower part of the pelvic plexus. It lies within the fascial shell of the prostate. The nerves composing it are of large size. They are distributed to the prostate seminal vesicle and the corpora cavernosa of the penis and urethra. The nerves supplying the corpora cavernosa consist of two sets, the lesser and greater cavernous nerves, which arise from the forepart of the prostatic plexus, and, after joining with branches from the pudendal nerve, pass forward beneath the pubic arch The pubic arch, also referred to as the ''ischiopubic arch'', is part of the pelvis. It is formed by the convergence of the inferior rami of the ischium and pubis on either side, below the pubic symphysis. The angle at which they converge is kno .... Injury to the prostatic plexus (during prostatic resection for example) is highly likely to cause erectile dysfunction. It is because of this relationship that surgeons are careful to maintain the integrity of ...
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Postganglionic
In the autonomic nervous system, fibers from the ganglion to the wikt:effector, effector organ are called postganglionic fibers. Neurotransmitters The neurotransmitters of postganglionic fibers differ: * In the parasympathetic division, neurons are ''cholinergic''. That is to say acetylcholine is the primary neurotransmitter responsible for the communication between neurons on the parasympathetic nervous system, parasympathetic pathway. * In the sympathetic division, neurons are mostly ''adrenergic'' (that is, epinephrine and norepinephrine function as the primary neurotransmitters). Notable exceptions to this rule include the sympathetic innervation of sweat glands and Arrector pili muscle, arrectores pilorum muscles where the neurotransmitter at both pre and post ganglionic synapses is acetylcholine. Another notable structure is the medulla of the adrenal gland, where chromaffin cells function as modified post-ganglionic nerves. Instead of releasing epinephrine and norepineph ...
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Parasympathetic
The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes considered an independent system. The autonomic nervous system is responsible for regulating the body's unconscious actions. The parasympathetic system is responsible for stimulation of "rest-and-digest" or "feed and breed" activities that occur when the body is at rest, especially after eating, including sexual arousal, salivation, lacrimation (tears), urination, digestion, and defecation. Its action is described as being complementary to that of the sympathetic nervous system, which is responsible for stimulating activities associated with the fight-or-flight response. Nerve fibres of the parasympathetic nervous system arise from the central nervous system. Specific nerves include several cran ...
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Penile Erection
An erection (clinically: penile erection or penile tumescence) is a physiological phenomenon in which the penis becomes firm, engorged, and enlarged. Penile erection is the result of a complex interaction of psychological, neural, vascular, and endocrine factors, and is often associated with sexual arousal or sexual attraction, although erections can also be spontaneous. The shape, angle, and direction of an erection varies considerably between humans. Physiologically, an erection is required for a male to effect vaginal penetration or sexual intercourse and is triggered by the parasympathetic division of the autonomic nervous system, causing the levels of nitric oxide (a vasodilator) to rise in the trabecular arteries and smooth muscle of the penis. The arteries dilate causing the corpora cavernosa of the penis (and to a lesser extent the corpus spongiosum) to fill with blood; simultaneously the ischiocavernosus and bulbospongiosus muscles compress the veins of the c ...
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Clitoral Erection
Clitoral erection is a physiological phenomenon where the clitoris becomes enlarged and firm. Clitoral erection is the result of a complex interaction of psychological, neural, vascular, and endocrine factors, and is usually, though not exclusively, associated with sexual arousal. Erections should eventually subside, and the prolonged state of clitoral erection even while not aroused is a condition that could become painful. This swelling and shrinking to a relaxed state seems linked to nitric oxide's effects on tissues in the clitoris, similar to its role in penile erection. Physiology The clitoris is the homologue of the penis in the female. Similarly, the clitoris and the erection of it can subtly differ in size. The visible part of the clitoris, the glans clitoridis, varies in size from a few millimeters to one centimeter and is located at the front junction of the labia minora (inner lips), above the opening of the urethra. It is covered by the clitoral hood. Any t ...
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Inferior Hypogastric Plexus
The inferior hypogastric plexus (pelvic plexus in some texts) is a network () of nerves that supplies the organs of the pelvic cavity. The inferior hypogastric plexus gives rise to the prostatic plexus in males and the uterovaginal plexus in females. The inferior hypogastric plexus is a paired structure, meaning there is one on the left and the right side of the body. These are located on either side of the rectum in males, and at the sides of the rectum and vagina in females. For this reason, injury to this structure can arise as a complication of pelvic surgeries and may cause urinary dysfunction and urinary incontinence. Testing of bladder function is used in that case to show a poorly compliant bladder, with bladder neck incompetence, and fixed external sphincter tone. Structure The plexus is formed from: * a continuation of the superior hypogastric plexus on either side, at the Sacrum Promontory in the interiliac triangle. At this location, the presacral nerve sits in the mi ...
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Pre-ganglionic
In the autonomic nervous system, fibers from the CNS to the ganglion are known as preganglionic fibers. All preganglionic fibers, whether they are in the sympathetic division or in the parasympathetic division, are cholinergic (that is, these fibers use acetylcholine as their neurotransmitter) and they are myelinated. Sympathetic preganglionic fibers tend to be shorter than parasympathetic preganglionic fibers because sympathetic ganglia are often closer to the spinal cord than are the parasympathetic ganglia. Another major difference between the two ANS (autonomic nervous systems) is divergence. Whereas in the parasympathetic division there is a divergence factor of roughly 1:4, in the sympathetic division there can be a divergence of up to 1:20. This is due to the number of synapses formed by the preganglionic fibers with ganglionic neurons. See also * Postganglionic fibers * Nerve fiber An axon (from Greek ἄξων ''áxōn'', axis), or nerve fiber (or nerve ...
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Pelvic Splanchnic Nerves
Pelvic splanchnic nerves or nervi erigentes are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the organs of the pelvic cavity. Structure The pelvic splanchnic nerves arise from the anterior rami of the sacral spinal nerves S2, S3, and S4, and enter the sacral plexus. They travel to their side's corresponding inferior hypogastric plexus, located bilaterally on the walls of the rectum. They contain both preganglionic parasympathetic fibers as well as visceral afferent fibers. Visceral afferent fibers go to spinal cord following pathway of pelvic splanchnic nerve fibers. The parasympathetic nervous system is referred to as the ''craniosacral outflow''; the pelvic splanchnic nerves are the ''sacral'' component. They are in the same region as the sacral splanchnic nerves, which arise from the sympathetic trunk and provide sympathetic efferent fibers. Function The pelvic splanchnic nerves contribute to the inner ...
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Prostatectomy
Prostatectomy (from the Ancient Greek language, Greek , "prostate" and , "excision") as a medical term refers to the surgical removal of all or part of the prostate gland. This operation is done for benignity, benign conditions that cause urinary retention, as well as for prostate cancer and for other cancers of the human pelvis, pelvis. There are two main types of prostatectomies. A simple prostatectomy (also known as a subtotal prostatectomy) involves the removal of only part of the prostate. Surgeons typically carry out simple prostatectomies only for benignity, benign conditions. A radical prostatectomy, the removal of the entire prostate gland, the seminal vesicles and the vas deferens, is performed for cancer. There are multiple ways the operation can be done: with open surgery (via a large incision through the lower abdomen), laparoscopy, laparoscopically with the help of a robotic surgery, robot (a type of minimally invasive surgery), through the urethra or through the ...
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Genital Modification And Mutilation
The terms genital modification and genital mutilation can refer to permanent or temporary changes to human sex organs. Some forms of genital alteration are performed on adults with their informed consent at their own behest, usually for aesthetic reasons or to enhance stimulation. However, other forms are performed on people who do not give informed consent, including infants or children. Any of these procedures may be considered modifications or mutilations in different cultural contexts and by different groups of people. Reasons Religious The vast majority of genital cutting in the world is done for religious motives (though not all members of genital cutting religions adhere to the practice). Genital cutting is performed for reasons such as: # Rite of passage: circumcision in Islam () is typically performed during childhood before puberty. In Judaism, the religious male circumcision ceremony () is usually performed on infants. # Expression of religious identity: both in Jud ...
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Nerve-sparing Surgery
Nerve-sparing surgery is a type of surgery that attempts to save the nerves near the tissues being removed. It is commonly applied in radical retropubic prostatectomy, a surgical treatment for prostate cancer, in which damage to nerves during surgery can lead to complications including urinary incontinence and impotence. In nerve-sparing radical prostatectomy, initially developed by Dr. Patrick Walsh in the 1980s, surgeons identify and attempt to avoid damaging the nerves. Surgeons may visually identify the cavernous nerves of penis or apply an electrical stimulation penile plethysmograph Penile plethysmography (PPG) or phallometry is measurement of blood flow to the penis, typically used as a proxy for measurement of sexual arousal. The most commonly reported methods of conducting penile plethysmography involve the measurement of ... diagnostic test to verify the nerves, and so avoid damaging them. The bilateral approach attempts to spare the nerves on both sides of the prosta ...
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