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Males clearly fixate on their penises, but most don’t really know what one consists of. Even physicians don’t ordinarily study the organ in depth. Medical students spend a semester learning the brain, but only a few minutes in lecture cover the penis. Gray’s Anatomy has more than twice as many pages on the nose as the penis. Illogical. When is the last time you heard men bragging about the size of their brain or nose?

The main bulk of the penis is composed of three tubes running lengthwise (see Fig. 1). On top are two side-by-side cylinders, each of which is called a corpus cavernosum (the plural of which is corpora cavernosa*). During erection the corpora cavernosae fill with blood under pressure, kind of like inflating a tire, or maybe an inflatable raft. We often refer to the cavernosae as the corporal bodies. A tough coat called the tunica albuginea surrounds each corpus cavernosum, like the steel belt of the radial tire. Another layer called Buck’s fascia wraps around both corpora cavernosae. (More proof anatomists have a sense of humor, contrary to popular wisdom.)

Immediately below the corpora cavernosae runs the third tube, called the corpus spongiosum.9″ The urethra carries urine and semen through the spongiosum to the tip of the penis. Here, the urethral meatus (the anatomists’ sense of humor at work again) forms a slit-like opening to the outside world. The spongiosum spreads out at the end of the penis to form the helmet-shaped glans penis or “head.” The glans penis holds the nerve fibers that give the penis its sensitivity. The rounded rim of the glans penis is called the corona. (We must wonder what beer anatomists drink.)
A hood of skin (the foreskin) covers the glans penis at birth. Its medical name is the prepuce. This is such a bad name that urologists use it only when writing scientific papers, and try to not say it aloud because few are sure how to pronounce it. Circumcised men have had the prepuce removed. The frenulum is the web of skin on the underside that seems to connect the used for sewing needles or toothpicks. This explains why people in ancient times frequently let things remain stuck between their teeth.

Leonardo da Vinci believed humans had a similar bone: “The origin of the penis is situated upon the pubic bones so that it can resist its active force on coitus. If this bone did not exist the penis, in meeting resistance, would turn backward and would often enter more into the body of the operator than into the body of the operated.”

The penis receives its blood supply from the pudendal arteries and veins. Once inside the penis, the arteries branch out and drain into sinusoids. These sacks can fill with pressure so the tire becomes inflated and rigid.

The penile nerves weren’t fully understood until recently. These tiny strands of tissue are hard to see, so they’re often overlooked by surgeons and anatomists alike. In 1981, Dr. Patrick Walsh was in the Netherlands to address a medical meeting. Since it was Dr. Walsh’s birthday, his hosts reserved a free afternoon for any leisure activity he desired. Most people could think of dozens of things to do for a birthday party in the Netherlands; he chose to spend the afternoon in the anatomic dissection lab on the host university’s campus exploring the exact route the nerves took through the pelvis en route to the penis. His discovery completely changed our understanding of this anatomy. Since we know where the nerves are located, we can now preserve them during urological surgery (see chapter 6). Already one of the preeminent urologists in the world, he thus secured his place in history.

And he didn’t have a headache the next day.

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