The hemodynamics of erection at the level of the penis and its local deterioration.

We have studied penile structure in 300 specimens from cadavers, 3,000 patients undergoing general physical examination and more than 700 patients operated on for organic impotence. Special attention has been focused on the closure mechanism of the corpora cavernosa during erection. Venous outlets of the corpora cavernosa normally are situated only on the distal third of the ventral penile surface. A firm, lasting erection requires a tight albuginea of the corpora cavernosa, with perfect closure of the venous outlets. During life use of the penis or, eventually, misuse by repeated long-lasting, firm erections (high pressure in the corpora cavernosa) results in deterioration of the tightness of the albuginea, especially when the albuginea is thin (25 per cent of the cases). We have found that a leakage factor of the corpora cavernosa is the most frequent cause of organic impotence in aging men.