The dorsal nerve of the penis (or clitoris) is the deepest terminal branch of the pudendal nerve, arising in Alcock canal and passing through the deep perineal pouch to enter the dorsum of the penis (or clitoris). It runs along the dorsum of the penis under Buck fascia to supply the glans penis with touch, pain, temperature sensation, and erogenous sensation. The cavernous nerves (from the pelvic plexus) are separate and carry autonomic fibres for erection.
The dorsal nerve of the penis is the sensory nerve for penile and clitoral sensation and is distinct from the cavernous nerves that mediate erection. Injury during pelvic surgery, prostatectomy, or perineal trauma produces penile anaesthesia with preserved erectile function if the cavernous nerves are intact. Pudendal nerve block at Alcock canal blocks the dorsal nerve and relieves clitoral and penile neuropathic pain. Dorsal neurectomy for premature ejaculation is a controversial procedure targeting this nerve.
Perineal urethral reconstruction, artificial urinary sphincter placement, and perineal prostatectomy risk the dorsal nerve of the penis in the deep perineal pouch, producing penile anaesthesia and reduced erogenous sensation; the autonomic cavernous nerves are separate and erectile function may be preserved even with dorsal nerve injury.
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