Erection (P oint) - P arasympathetic - P elvic S planchnics S2-4 (S2,3,4 keep the penis off the floor). This is mediated by the release of Nitric Oxide and an increased intracellular cGMPG concentration and resulting vasodilation. PDE-5 inhibitors (such as sildenafil or Viagra) inhibit the breakdown of cGMP and maintain erections.
Anti-erection (S quander) - S ympathetic - Prostatic Plexus Cavernous and Pudendal nerves. This is mediated by Norepinephrine and an increased intracellular Calcium concentration and resulting in smooth muscle contraction and vasoconstriction.
Emission (S queeze) - S ympathetic - Hypogastric T11-L2
Expulsion (S hoot) - S omatic (and Visceral) - Pudendal
shak360It is commonly tested that the afferent component of the erection pathway is done by the Pudendal nerve. The pudendal nerve does sensory for the perineum and motor for the external urethral (expulsion) and anal sphincters. It can often be injured in childbirth, PROLONGED CYCLING (see question NBME 25 Block 1 Question 30 which asks what neve is injured in a patient with numbness of the penis, and difficulty achieving and maintaining an erection, and is a competitive bicyclist.+1
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Autonomic innervation of the male sexual response
Erection (P oint) - P arasympathetic - P elvic S planchnics S2-4 (S2,3,4 keep the penis off the floor). This is mediated by the release of Nitric Oxide and an increased intracellular cGMPG concentration and resulting vasodilation. PDE-5 inhibitors (such as sildenafil or Viagra) inhibit the breakdown of cGMP and maintain erections.
Anti-erection (S quander) - S ympathetic - Prostatic Plexus Cavernous and Pudendal nerves. This is mediated by Norepinephrine and an increased intracellular Calcium concentration and resulting in smooth muscle contraction and vasoconstriction.
Emission (S queeze) - S ympathetic - Hypogastric T11-L2
Expulsion (S hoot) - S omatic (and Visceral) - Pudendal