Anatomy of the dorsal nerve of the penis, clinical implications.

Objective: To show the branching patterns and the anatomic variations of the dorsal nerve of the penis (DNP) along the penile shaft, particularly the relation with the tunica albuginea.

Methods: The penises of 22 adult cadavers were dissected. The number and the diameters of the branches, the presence of anastomoses between the main trunks, the positioning of the nerves before entering the glans penis, and the presence of branches emerging from the body of the DNP and perforating the tunica albuginea were noted and photographed. The compartments where the anatomic findings were located were noted.

Results: The DNP was composed of 2, 3, 4, 5, and 6 main branches in 6 (27.3%), 6 (27.3%), 6 (27.3%), 1 (4.5%), and 3 (13.6%) of 22 dissections, respectively. We could trace 2, 3, 4, and 5 terminal branches of the DNP going into the glans penis in 4 (18.2%), 8 (36.4%), 7 (31.8%), and 3 (13.6%) dissections, respectively. In 2 dissections (9.1%), fine branches were present between the main trunks crossing the midline. Anastomosing branches between ipsilateral main trunks of the DNP were identified in 5 dissections (22.7%). In 16 (72.7%) dissections, branches emerging from the inferior aspect of the body of the DNP, which perforated the tunica albuginea, could be identified.

Conclusion: The exact anatomic knowledge of the DNP is mandatory during penile reconstructive surgeries. The presence of branches perforating the tunica albuginea is the most important finding of this cadaveric study, together with the other documented variations, which must be taken into consideration during penile reconstructive surgeries.