How to examine the corpus cavernosum of the penis

The corpus cavernosum of the penis plays an important role in male erection. If the corpus cavernosum is damaged, the patient may not be able to have an erection. If you want to examine the corpus cavernosum of the penis, you can use more professional methods, such as drug-induced cavernography, continuous infusion angiography, etc.

(1) Pharmacological cavernography

After the iodine allergy test, the penile skin is routinely disinfected. After applying pressure to the base of the penis with a rubber band, a 7-gauge needle is used to inject vasoactive substances, such as castor oil and prostaglandin E1, into the posterior 1/3 of the penis. After observing the penis erection for 15 minutes, 80 ml of 30% diatrizoate is selected and injected directly into the corpus cavernosum on one side. After satisfactory imaging, anteroposterior and left and right oblique films are taken.

(2) Continuous infusion angiography

After the injection of vasoactive substances in the corpus cavernosum of the penis, if the erection is below 60 degrees or disappears quickly, and the penile arterial system is examined within the normal range, a Swiss Gombro perfusion pump is used to automatically control the flow rate of the liquid per minute. The patient lies flat and is disinfected routinely. One end of the catheter connected to the perfusion pump is connected to a No. 9 needle and inserted into the corpus cavernosum of the penis on one side. The other end of the catheter is connected to an infusion bottle. Normal saline is injected at a flow rate of 80 to 120 ml per minute to directly induce penile erection. The flow rate at the beginning of the erection is recorded, and then the flow rate is slowed down to maintain the erection and the speed of maintaining the erection is recorded. Finally, 100 ml of 30% diatrizoate is injected and films are taken under the monitoring of a fluorescent screen. After the film is taken, the needle is removed and local pressure is applied for 3 to 5 minutes.

Normal imaging is symmetry of the corpora cavernosa on both sides, even distribution of contrast agent, uniform density, smooth edges, clear septa, and symmetry of the left and right crus. The X-ray shows that the crus is "separated" from the sciatic ramus, and observe whether the penile venous system is visible. If the penile vein is visible, common types include dorsal penile vein leakage, crus leakage, corpora cavernosa septum leakage, ectopic venous leakage, corpus cavernosum, and mixed types.

Penile corpus cavernosum is a relatively direct examination for understanding abnormalities of the penile venous system. It can reflect the pathway of penile venous reflux, the internal structure and pathological changes of the penile corpus cavernosum, and provide comprehensive considerations for penile vascular reconstruction or penile prosthesis implantation. However, it is an invasive examination and the indications should be strictly controlled.