Cavernous nerves

Cavernous nerves are a pair of nerves that are critical in the process of penile erection. They are part of the autonomic nervous system and are predominantly parasympathetic in nature. The cavernous nerves are located bilaterally in the male pelvis, running alongside the prostate and entering the corpora cavernosa to influence the vascular dynamics of the penis.

Anatomy

The cavernous nerves originate from the pelvic plexus, a complex network of nerves situated in the deep pelvis, behind the rectum and in front of the sacrum. The pelvic plexus receives input from both the sympathetic and parasympathetic nervous systems, via the hypogastric nerves and the pelvic splanchnic nerves, respectively.

From the pelvic plexus, the cavernous nerves travel downwards and laterally, passing the prostate to enter the corpora cavernosa. Here, they release neurotransmitters that cause the smooth muscle in the blood vessels of the penis to relax, leading to increased blood flow and penile erection.

Clinical significance

The cavernous nerves are vulnerable to damage during surgical procedures in the pelvis, particularly during radical prostatectomy for prostate cancer. Damage to these nerves can result in erectile dysfunction, a common complication of prostate surgery.

Several techniques have been developed to preserve the cavernous nerves during surgery, including nerve-sparing prostatectomy and the use of nerve grafts. In addition, drugs such as phosphodiesterase type 5 inhibitors (e.g., sildenafil) can be used to manage erectile dysfunction post-surgery.

See also

• Nervous system
• Erection
• Prostate cancer
• Erectile dysfunction