Perforating arteries of penis

The perforating arteries of the penis are small arterial branches that traverse (perforate) the tunica albuginea to create anastomotic connections between the major penile arterial systems primarily between the dorsal arteries and the cavernous (deep) arteries of the penis.

The penile arterial supply derives from the internal pudendal artery, which terminates as three paired arteries: the cavernous (deep) artery, the dorsal artery, and the bulbourethral artery. The perforating arteries arise as branches from one system and pierce the tunica albuginea to communicate with the other. Two main types have been described:

• Perforating branches of the dorsal artery: These are small arteries (typically 2-4 per penis) that arise from the dorsal penile arteries and penetrate the tunica albuginea to join the cavernous artery or independently vascularize the distal third of the corpora cavernosa. In a computer-assisted anatomic dissection study, these perforating branches were found in four of five specimens, demonstrating that the cavernous artery is not the sole source of corporal blood supply.

• Perforating branches of the cavernous artery: These arise at regular intervals (6-10 per penis) from the cavernous arteries and perforate the tunica albuginea vertically to anastomose with the urethral arteries on the surface of the tunica albuginea. These were historically termed "cavernospongious shunts," though anatomic studies have confirmed they are purely arterio-arterial anastomoses rather than arteriovenous shunts.