THE ANATOMY OF THE TUNICA ALBUGINEA IN THE NORMAL PENIS AND PEYRONIES-DISEASE

Purpose: We studied the fine architecture of the tunica albuginea of t he penis. Materials and Methods: The study included 6 human male cadav ers and 10 surgical patients (5 with Peyronie's disease and 5 with nor mal penile anatomy). Results: The tunica albuginea of the corpora cave rnosa is a bi-layered structure with multiple sub layers. Inner layer bundles support and contain the cavernous tissue and are oriented circ ularly. Radiating from this layer are intracavernous pillars acting as struts, which augment the septum and provide essential support to the erectile tissue. Outer layer bundles are oriented longitudinally. The se fibers extend from the glans penis to the proximal crura, where the y insert into the inferior pubic ramus. There are no outer layer fiber s between the 5 and 7 o'clock positions. Elastic fibers normally form an irregularly latticed network on which collagen fibers rest. In Peyr onie's disease the well ordered appearance of the collagen layers is l ost: excessive deposits of collagen, disordered elastic fibers and fib rin are found within the region of the plaque. Conclusions: The normal 3-dimensional structure of the tunica affords great flexibility, rigi dity and tissue strength to the penis, which are lost consequent to st ructural changes in Peyronie's disease.