(067) How Many Nerve Fibers Innervate the Human Glans Penis: A Histomorphometric Analysis of the Human Dorsal Nerve of the Penis
Bibliographic record
Abstract
Abstract Introduction The mainstream media has frequently quoted that the penis has “half as many” nerve fibers as the human clitoris. Recent work has demonstrated that the number of nerve fibers in the dorsal nerve of clitoris was under-estimated, and no study has yet quantified the number of axons in the human dorsal nerve of the penis (DNP). Improving our understanding of penile innervation and sexual response has potential implications for fields of medical and surgical practice. Several nerve transfers have recently emerged targeting the DNP for re-innervation in order to restore penile sensation and/or erectile function, demonstrating variability in outcomes. Understanding the axon counts of the DNP at the anatomic level that these nerve transfers are performed may inform technical refinements and improve our understanding of current outcomes. Comparing DNP axon counts to the recently reported axon counts of the dorsal nerve of the clitoris may also inform techniques in transgender genital surgery, anticipate sensory outcomes in penile allotransplantation and further our understanding of sexual responses across genitalia. Objective The objective of this study is to quantify the number of axons in the human dorsal nerve of the penis. Methods Bilateral DNP samples were obtained from 5 fresh frozen cadavers. Samples were collected at the base of the penis at the level of the pubic symphysis, a location commonly targeted for coaptation in nerve transfers. Specimens were placed in 3% glutaraldehyde, post-fixed in 1% osmium tetroxide and serially dehydrated in ethanol and toluene. They were embedded in araldite, sectioned on ultramicrotome into 1 μm cross-sections and counter-stained with 1% toluidine blue. Histomorphometric evaluation was performed at 1000x magnification using Leitz Laborlux S microscope and image analysis software (Clemex Vision Professional, Longueuil, Quebec) to obtain nerve fiber counts from each specimen (Figure). Results 10 DNP samples were analyzed. The mean number of axons in the human dorsal nerve of penis was 3,844 +/- 1,238 (range 1,915 to 5,494). Accounting for the bilaterality of the DNP, the mean total number of axons innervating the human glans penis was 7,688 +/- 1,762. Conclusions This study is the first to report the number of axons in the human dorsal nerve of the penis and approximate the number of axons innervating the human glans penis. At the level of the pubic symphysis, axon counts of the dorsal nerve of penis varied significantly and averaged 3,844. The variation in axon counts at this anatomic level was greater than seen in prior reports on the DNC and may be one factor contributing to variations in outcomes following nerves transfers for penile sensation and erection. This variation could also reflect the anatomic level of sample collection or differences in specimen origin (cadaver vs. live person). DNP axon counts were less than or equal to recently reported axon counts of the human glans clitoris, despite the much larger size of the glans penis. This finding may be important when considering clitoral construction in transgender genital surgery, penile allotransplantation and different in sexual responsiveness across genitalia. Disclosure No.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".