What is it about?

This paper explores the structural and functional failures that lead to erection abnormalities. It categorizes them into two main types: Shape Problems (Dysmorphology): Conditions like Peyronie's disease or congenital curvature. The research identifies that these are caused by asymmetrical development or fibrous plaques in the tunica albuginea (the penis's fibrous coat). Specifically, defects in the outer longitudinal layer of this coat are responsible for the curvature. Rigidity Problems (Erectile Dysfunction): The paper highlights Penile Veno-Occlusive Dysfunction (venous leakage) as a leading cause of ED. This occurs when the venous system fails to close properly, preventing the penis from trapping blood. Congenital Defects: Rare conditions such as aphallia (absence of the penis) or diphallia (duplication of the penis) resulting from embryonic development errors.

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Why is it important?

It Pinpoints the "Leak": It establishes that for many men, ED is not just hormonal or psychological, but a mechanical failure of the veins (venous incompetence). It Explains Curvature: It identifies the specific anatomical layer (the outer longitudinal coat) responsible for penile shape. This knowledge is crucial for surgeons to correct curvature without damaging the inner layer that holds the blood. It Offers New Solutions: With 30% of ED patients failing to respond to pills (PDE5 inhibitors), this research validates surgical alternatives like venous stripping and tunical patching to physically repair the leakage points and deformity.

Perspectives

Erection abnormalities are often mechanical failures of the 'fibro-vascular assembly.' Whether it is a curvature caused by an asymmetrical tunica albuginea or erectile dysfunction caused by leaking emissary veins, these are structural defects. Our research suggests that correcting the anatomy—through venous stripping or reconstruction—can restore function where medication fails

Professor Geng-Long Hsu
Microsurgical Potency Reconstruction and Research Center, Hsu’s Andrology

Read the Original

This page is a summary of: Erection Abnormality, January 2026, Elsevier,
DOI: 10.1016/b978-0-443-21477-6.00465-x.
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