The ischiocavernosus covers the crus of the penis or clitoris, compressing it to maintain erection by preventing venous outflow. It contributes to the rigidity phase of erection alongside the bulbospongiosus. Electromyographic studies confirm rhythmic ischiocavernosus contractions during orgasm. The muscle is accessed during pudendal nerve decompression and perineal surgery.
| Origin | Inner surface of the ischial tuberosity and ischiopubic ramus |
|---|---|
| Insertion | Crus of the penis or clitoris — compresses the crus against the pubic arch |
| Nerve Supply | Perineal branch of the pudendal nerve (S2, S3, S4) |
| Blood Supply | Perineal artery |
| Actions | Maintains erection by compressing the crus of the penis/clitoris to impede venous drainage and maintain intracorporal pressure; Contributes to orgasm through rhythmic contractions |
|---|
Perineal reconstruction after radical prostatectomy or vulvar surgery may involve the ischiocavernosus in flap design. Pudendal neuralgia affecting the perineal branch produces ischiocavernosus pain reproduced by perineal pressure.
Not directly palpable as a distinct structure from the perineal surface.
Ischiocavernosus trauma from straddle injury producing perineal pain and bruising managed conservatively.
