Urethra:

Arteries:
1) Urethral artery: from internal pudendal artery/common penile
2) Dorsal penile artery: on each side circumflex branch; retrograde via terminal branches
Venous:
1) Anterior urethra:
a) Prostatic plexus (dorsal veins of penis & internal pudendal veins)
2) Posterior urethra:
a) Prostatic and vesical venous plexus => internal iliacs
Lymph:
1) Posterior urethra: Internal iliac (mainly) & external iliac
2) Membranous urethra: accompany internal pudendal artery
3) Anterior urethra: deep inguinal nodes, superficial nodes, external iliac nodes
Innervation:
1) Internal urethra: sympathetic nerves from pelvic plexus; prevent retrograde ejaculation
2) Prostatic urethra: prostatic plexus (from pelvic plexus)
3) Membranous: pierced by onuf’s nucleus + pelvic plexus they run on pelvic aspect of floor
4) Bulbous spongiosum: cavernous nerves
5) External urethra: Onuf’s nucleus, perineal branches of pudendal nerve (S2-S4 for both)
6) Parasympathetic from S2-S4
Ductus Deferens:
1) Course: medial to epididymis => posterior part of spermatic cord => lateral to inferior
epigastric artery (at deep inguinal ring) => crosses external iliac artery to enter pelvis =>
descend into pelvis medial to obturator and umbilical arteries and nerves => crosses
ureter and passes onto the base of the bladder => descends on the base medial to the
seminal vesicle (becomes dilated and called ampulla) (seperated from rectum by
denonvillier’s fascia) => base of prostate joins with seminal vesicle to form ejacolatory
duct
2) Arteries: Superior vesical
3) Veins: to pelvic plexus
4) Lymph: External, internal iliacs
5) Nerves: autonomic from pelvic plexus
Seminal vesicles:
1) Medial to the prostatic venous plexus
2) Arteries: middle rectal, seminal vesicle. Veins and lymph accompany them.
3) Innervation: pelvic plexus
Prostate:
1) Posterior to the arch of the pubis.Urethra passes between anterior and middle 3rds.
Ejacolatory ducts pass anteroinferiorly through its posterior region to open into prostatic
urethra.
2) Arteries: inferior vesical, internal pudendal, middle rectal
3) Veins: anterolaterally form a plexus. Drain into vesical and internal iliac veins. Deep
dorsal vein of th penis is the main tributary.
4) Lymph: internal iliac, sacral and obturator nodes
 5) Nerve: pelvic plexus (inferior hypogastric plexus). Posterolateral nerves to the prostate
are usually injured during surgery => impotence
Spermatic cord:
Coverings:
1) 3 layers of fascia form the spermatic cord. Extends from testis to deep inguinal ring
2) Cremasteric fascicles: derived from internal oblique, loop around the cord and insert into
pubic tubercle.
3) Internal spermatic fascia is derived from fascia transversalis
4) External spermatic fascia is derived from from external oblique
5) Processus vaginalis is derived from parietal peritoneum
6) Transversus abdominis doesn’t contribute
Contents:
1) Ductus deferens
2) Arteries: testicular artery, artery of ductus deferens, cremasteric artery
3) Veins: pampiniform plexus and cremasteric (in inguinal canal may be 4 but in
deep ring are 2, in lower part of posterior abdominal wall they are 2 but in the
upper part of posterior abdominal wall they are 1)
4) Nerves: sympathetic nerves to the testis, epididymis, and ductus deferens and
the genital branch of the genito-femoral
5) Lymphatics
6) Vestigial remnant of the processus vaginalis

Scrotum:
1) made of skin and Dartos muscle
2) Scrotal septum formed from Dartos muscle and the cord’s coverings. It is incomplete.
3) The posterior part of the testis adheres to scrotum (not covered by tunica)
4) Arteries and veins:
a) Superficial external pudendal (branch of femoral artery)
b) Deep external pudendal (branch of femoral artery)
c) Internal pudendal artery
d) Cremasteric branch from inferior epigastric artery
5) Lymph; accompanying external pudendal vessels to superficial inguinal nodes
6) Nerve:
a) Anterior 1/3rd: Ilioinguinal (L1) and Genitofemoral (L1)
b) Posterior 2/3rd: Perineal nerve (S3) and posterior femoral cutaneous (S3)
Testis:
1) Arteries:
a) Testicular artery arises from aorta a little inferior to the renal arteries.
b) Cremasteric branch of the inferior epigastric artery, and from the artery to the vas
deferens
2) Veins:
a) Posterior to testis, from pampiniform plexus that ascends anterior to vas deferens => in
the inguinal canal drained by 2-4 veins which run into the abdomen through the deep
 inguinal ring => in abdomen these veins become 2 which ascend on each side of the
testicular artery.
b) Right testicular vein opens into IVC inferior to renal veins at an acute angle. Left
testicular vein opens into left renal vein at a 90 degree angle.

3) Lymph: start in superficial plexus under tunica vaginalis => 4-8 collecting trunks ascend
in spermatic cord near testicular vessels => lateral aortic and pre-aortic nodes
4) Nerve: T10-T11 via renal and aortic autonomic plexus

Perineum:
Boundaries:
1) Anteriorly: inferior border of symphysis pubis and arcuate pubis ligament
2) Laterally: inferior pubic ramus, ischial ramus, ischial tuberosity, sacrotuberous ligament
3) Posteriorly: tip of coccyx
Urogenital triangle:
Boundaries:
1) Above by inferior surfaces of the levator ani
2) Laterally by the inferior border of the symphysis pubis, ichiopubic rami
3) Inferiorly by superficial perineal fascia (Colle’s fascia) (in the scrotum Colle’s fascia is
permeated by smooth muscle fibers that form the dartos muscle, in the body of penis it is
called dartos fascia)
Colle’s fascia:
1) Attached to ischiopubic rami and posterior border of perineal membrane.
2) Anteriorly it is continuous with fascia of Scarpa
3) Fluid under Colle’s fascia can spread to the anterior abdominal wall, scrotum, and penis.
Perineal membrane:
1) Stretches between ischiopubic rami
2) Posterior border blends with Colle’s fascia => closing subcutaneous perineal pouch
posteriorly
3) Anterior border separated from arcuate pubic ligament by a gap through which deep
dorsal vein of the penispass to join the prostatic plexus of veins.
4) Perineal membrane separates superficial and deep perineal pouches (deep perineal
pouch contains the external urethral sphincter complex and is continuous with the
anterior recesses of the ischio-anal fossa)
Deep perineal pouch contents:
1) External urethral sphincter
2) Right and left deep transverse perineal muscles
3) Bulbourethral glands
4) Vessels and nerves
5) Membranous urethra
Superficial perineal pouch contents:
1) Root of penis (right and left crura +bulb of penis)
2) Right and left ischiocavernosus, bulbospongiosus, and superficial transverse perineal
muscles
Urogenital diaphragm:
1) Urogenital diaphragm = external urethral sphincter + deep transverse perineal muscles +
perineal membrane
2) Traversed by membranous urethra
Subcutaneous perineal pouch communicates with:
1) Space deep to the dartos muscle
2) Scarpa’s fascia of lower abdominal wall
Ischioanal fossa has extensions into deep perineal pouch, anterior recesses of ischioanal fossa