Suspension of the penis - dissection, anatomical description and highlighting of anatomical risks in sectioning the suspensory ligaments

BackgroundThe suspension of the penis is provided by two ligaments: fundiform and suspensory. These ligaments are sectioned during some augmentative surgical procedures. The structure, the relations and the variability of these ligaments have been demonstrated. The penile neurovascular bundle and its relationships have also been emphasized. A clear knowledge of these details should ensure a reduction of the risk of surgical injury during augmentation procedures.ResultsWe dissected the ligaments providing the suspension of the penis in 7 formalized corpses. We identified, for each of the ligaments, the origin, the insertion and the relations. The dissection pieces were photographed and the images obtained were discussed upon. We described the variability of the anatomical distribution and highlighted the relations with the vascular and nervous structures for each of these ligaments. The anatomical variability of the fascia and the relations with the base of the penis were also emphasized. For the suspensory ligament, we identified three groups of fibers through which it is attached to the penile body.ConclusionsThe dissections were conducted in layers, corresponding to the operative steps for the penile augmentation procedures. We believe that our study highlights the anatomical basis necessary to safely perform these surgeries. The study contributes to the description of the anatomical variability of the ligaments and logically presents details that contribute to preventing most surgical incidents. ContexteLa suspension du penis est assuree par deux ligaments: fundiforme et suspenseur. Ces ligaments sont sectionnes lors de certaines interventions chirurgicales d'agrandissement penien. La structure, les relations, et la variabilite de ces ligaments ont ete demontrees. Le faisceau neurovasculaire penien et ses relations ont egalement ete soulignes. Une connaissance claire de ces details devrait assurer une reduction du risque de blessure chirurgicale pendant les procedures d'augmentation.ResultatsNous avons disseque les ligaments assurant la suspension du penis sur 7 cadavres standardises. Nous avons identifie, pour chacun des ligaments, l'origine, l'insertion et les relations. Les pieces de dissection ont ete photographiees et les images obtenues ont ete discutees. Nous avons decrit la variabilite de la distribution anatomique, et mis en evidence les relations avec les structures vasculaires et nerveuses pour chacun de ces ligaments. La variabilite anatomique du fascia et les relations avec la base du penis ont egalement ete soulignees. Pour le ligament suspenseur, nous avons identifie trois groupes de fibres par lesquelles il est attache au corps penien.ConclusionsLes dissections ont ete effectuees en couches, correspondant aux etapes operatoires des procedures d'augmentation du penis. Nous pensons que notre etude met en evidence la base anatomique necessaire pour effectuer ces chirurgies en toute securite. L'etude contribue a la description de la variabilite anatomique des ligaments et presente logiquement des details qui contribuent a prevenir la plupart des incidents chirurgicaux.

Automated summary

The study provides detailed anatomical information about the suspension ligaments of the penis, as well as their relations with the vascular and nervous structures. This knowledge can greatly reduce the risk of surgical injury during penile augmentation procedures. The study also highlights the anatomical variability of the ligaments and presents important details for preventing surgical incidents.