What is it about?
Penile fibrovascular assembly is an independent structure that attaches to the pelvic wall for support and function. The integrity of the ligaments is deemed essential. Ligaments to the penis are likened to ropes or belts to a parachutist, akin to the entire penile body to the parachutist, and the ligaments are likened to the controlling belts. Any surgical attempt to alter their physiological or anatomical integrity will compromise penile fibro-vascular function.
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Why is it important?
Although human beings have existed on Earth for 30,000,000 years, penile anatomy has as well. In human anatomy literature, penile anatomical descriptions have been dominated by the traditional portrayal, presumed by Sage da Vinci before 1519. This article combines analyses from multiple sources, including anatomical dissection, conventional radiography, and advanced imaging techniques. Including CT and MRI, with surgeries elsewhere reciprocated. As anatomical knowledge is indispensable to surgery, a surgical strategy is advised to meet the organ anatomy and physiology as well
Perspectives
These innovative findings appear valuable to surgeons, researchers, and patients. As evidence speaks volumes, practice is the exclusive method for testing the truth. Surgeons should be cautious when making anatomical incisions in the macacian-like independent hydraulic compartment, particularly the corpora cavernosa, as this indicates that the applied pressure is undiminished across all portions of the enclosed container, even in the absence of veno-occlusive dysfunction.
Dr. Geng Long Hsu
The Surgeon's View (Dr. Hsu): This study fundamentally changes how we must approach penile surgery. For decades, anatomy textbooks simplified the penis’s suspension to just one or two ligaments. Our research identifies ten distinct fibrous ligaments that act as the structural "guy wires" of the penis. A surgeon cannot simply cut through tissue to access the deep structures without consequence. Preserving or reconstructing these specific ligaments is mandatory to maintain the penis's natural erection angle and stability. If you destroy this assembly, you might get a rigid penis (via implant or vascular repair), but it will be mechanically unstable or point downwards. The Scientific View: This is a redefinition of penile biomechanics. It moves away from the "hydraulic" model (just blood pressure) to a "tensegrity" model (fluid pressure balanced by tension elements). It proves that erection is a collaborative effort between the vascular system (filling) and this specific fibrous-ligamentous complex (anchoring). The Patient's View: This explains the "why" behind successful vs. unsuccessful outcomes. Patients who experience a "wobbly" erection or a loss of upward angle after trauma or previous surgeries finally have an anatomical explanation: one or more of these ten critical ligaments were compromised. It emphasizes that a "normal" erection requires structural support, not just hardness.
Professor Geng-Long Hsu
Microsurgical Potency Reconstruction and Research Center, Hsu’s Andrology
Read the Original
This page is a summary of: The Human Penile Fibro-Vascular Assembly Requires the Integrity of Ten Fibro-Ligaments, Life, September 2025, MDPI AG,
DOI: 10.3390/life15091492.
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