Related Experiment Video
Updated: Feb 4, 2026
Adult Mouse Venous Hypertension Model: Common Carotid Artery to External Jugular Vein Anastomosis.
Published on: January 27, 2015
Inferior External Pudendal Artery Anastomosis: Additional Approach to Prevent Skin Necrosis in Replanted Penis
Suphalerk Lohasammakul1, Chairat Turbpaiboon1, Rosarin Ratanalekha1
1From the Division of Plastic and Reconstructive Surgery, Department of Surgery, the Department of Anatomy, and the Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University; and the Department of Medicine, Mayo Clinic College of Medicine and Science.
Background:
Microsurgical anastomosis of the dorsal artery of the penis either with or without anastomosis of the cavernosal artery is the preferred technique for penile replantation. However, postoperative penile skin necrosis is commonly reported with this technique. This study aimed to characterize the anatomy of the vascular supply of the penis pertinent to penile replantation surgery and to report a successful case of penile replantation without postoperative necrosis using anastomosis of the inferior external pudendal artery.
Methods:
The authors dissected 15 penises of fresh cadavers under acrylic dye injection by means of the inferior external pudendal and dorsal arteries of the penis to identify vascular anastomoses between arteries supplying the penis and to measure other parameters of the arteries.
Results:
Mean diameters at the base of the penis of the inferior external pudendal, dorsal, and cavernosal arteries were 0.94, 1.43, and 0.80 mm, respectively. Penile skin is mainly supplied by the inferior external pudendal artery under three patterns with anastomoses across the midline. Preputial skin receives additional blood supply from perforators of the dorsal artery without visible anastomosis between the perforators and the inferior external pudendal artery. Deep structures receive blood supply from the dorsal, cavernosal, and urethral arteries, with visible anastomoses between the arteries. In a patient with amputated penis, the inferior external pudendal artery diameter was 0.7 mm, which was sufficient for microsurgical anastomosis. No postoperative necrosis developed, and patency of the inferior external pudendal artery was confirmed with duplex ultrasound.
Conclusion:
The diameter of the inferior external pudendal artery at the base and midshaft of the penis is sufficiently large for microsurgical anastomosis, and additional vascular anastomosis of at least one inferior external pudendal artery may help to prevent postoperative penile skin necrosis.
Clinical Question/Level Of Evidence:
Therapeutic, V.
Related Concept Videos
01:16Necrosis
Morphological Manifestations of Necrosis
Necrotic cells show different types of morphological appearance depending on the type of tissue and infection. In coagulative necrosis, cells become...
01:29Penis
Anatomy of the Penis
The glans penis, or the head, is the terminal part of the penis and houses the external urethral orifice, the exit point for urine and semen. Covered by the prepuce, or foreskin, the glans is noted for its sensitivity and plays a key role in sexual pleasure. The body of the...
01:26Coronary Artery Disease IV: Preventive Measures
01:27Conjugate Addition (1,4-Addition) vs Direct Addition (1,2-Addition)
Conjugate addition results in a thermodynamically stable product. The reaction retains the stronger C=O bond at the expense of the weaker C=C π bond. The process is slow as the β carbon is less electrophilic than the carbonyl carbon.
Direct addition products are...
01:11Work Done on a System by External Force
In the presence of a non-conservative opposing force, like friction, some part of the work done...
01:08Conjugate Addition of Enolates: Michael Addition