Penile pain is considered a rare form of chronic pelvic pain (3). Most cases of penile pain result from pain being referred from other areas, such as the prostate (prostatitis—see above) and scrotum (genitofemoral neuralgia—see below). The cause of penile pain could result from one of the many conditions that can affect the penis, such as Peyronie’s disease (formation of fibrosis in the erectile tissue causing curvature in the penis at erection) , paraphimosis(restriction of glans penis with retracted foreskin), and priapism (painful, persistent erection) . Some reported cases of penile pain are due to penile fracture , which involves the rupturing of the tunica albuginea of the corpus cavernosa when the penis is erect.
The dorsal nerve of the penis provides most of the sensory innervation of the penis . Gross dissection of human cadavers showed that the ilioinguinal nerve participates in innervating part of the proximal penile skin in about 30% of the examined specimens.
The cavernous nerve, which exits from the pelvic plexus, may also contain some afferent fibers originating from the penis, which reach the spinal cord via the pelvic nerve after passing through the pelvic plexus . Neuroanatomical studies on rats show that sensory innervation of the penis by the dorsal
nerve of the penis contains afferent fibers with cell bodies located mainly in the L6 dorsal root ganglion . The dorsal nerve of the penis is the last branch of the pudendal nerve , which innervates other regions such as the scrotum and perineum The penile afferents terminate in a large area in the spinal cord. Studies in rats show that stimulation of the dorsal nerve of the penis produce c-fos labeling in the dorsal horn and dorsal gray commissure throughout the L5-S1 spinal cord . Some studies have revealed some of the supraspinal areas that receive nociceptive inputs from the penis, which could participate in nociceptive processing and ultimately perception of penile pain. For example, electrophysiological studies on rats showed that single neurons in the medullary reticular formation and different thalamic subnuclei respond to electrical stimulation of the dorsal nerve of the penis and mechanical stimulation of penis, including pinch. The location of ascending spinal projections includes pathways located in the dorsal half of the spinal cord
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