Angelo Dillahunty

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The visible penis consists of two sections - the penis head or glans penis and the penile shaft. However, the penis continues as a hidden structure laying under the scrotum and reaching further backward in the perineal area towards the prostate. When the penis is erect, also the perineum, the area between the legs will be swollen.

The urinary tube (urethra) goes from the bladder, then through the prostate, then enters this penile structure just beneath the prostate and then goes forward all the way to the tip of the penis.

THE ERECTILE BODIES

In the visible penis and in the structure extending backwards there are three bodies that swell during erection, erectile bodies. The bodies are mostly made of a tight mesh of fine blood vessels with very elastic walls. There are two bodies along the upper part of the penis (corpora cavernosa) that extend backwards under the scrotum. Then there is one body around the urethra (corpus spongiosum) that continues backwards to just under the prostate.

The arteries leading blood to the erectile bodies and the veins leading blood from these bodies have muscles in their walls that can close off or relax to regulate the blood flow to and from these bodies.

When the muscles at the entrance relax and those at the outlet constrict, blood is filled into the mesh by the blood pressure. The erectile bodies will then engorge as a balloon and get straight. The swelling and straightening of the erectile bodies will inflate the whole penis and make it erect. This activity is regulated by nerve impulses and the substance nitrogen oxide working as a local tissue hormone.

All the inner structures of the penis are surrounded by a robust sheet of elastic connective tissue, the fibrous envelope. In the area between the legs there is a sheet of muscles between the fibrous envelope and the perineal skin, the two bolbospongiosus muscles. These muscles contract during ejaculation and help to pump out the semen.

THE PENILE SKIN

The penile skin is thick and robust. Between the skin and the fibrous envelope, there is a thin area consisting of a soft and extremely elastic connective tissue. Therefore the skin can easily be moved up and down along the penile shaft.

The penis head is covered by a thin skin which is extremely sensitive by means of a rich innervation. Still this thin skin is both strong and elastic. In addition the skin in an uncircumcised penis is covered by a hood that is not stuck to the surface of the head after early infancy, the foreskin.

The foreskin is a continuation of the skin covering the shaft that goes to the tip of the penis and is then folded back inwards, making a double layer, where the inner fold is fastened just under the penis head. Between the two folds there are an extremely soft and elastic tissue.

The foreskin can easily be retracted to show the bare penis head, and it uses to retract itself when the penis is erect. When the penis is not erect, the foreskin protects the penis head.

In early infancy the foreskin is fixed to the penis head, but will gradually loosen, usually during early infancy, but in a preteen boy there can still be some adhesions left around the base of the head.

In some cultures it is custom to remove the foreskin for various reasons by an operation called circumcision., making the penis head permanently exposed and visible. When circumcision is done in early infancy, the procedure also involves tearing the fixed foreskin loose from the surface of the head.

The skin of the penis head produces a white creamy substance called smegma which helps to lubricate the penis during intercourse. Smegma is a blending of oils secreted through the skin on the glans, cells loosened from the skin surface and substances produced by sebaceous glands on the inside of the foreskin. With improper hygiene too much smegma can accumulate and give excessive bacterial growth and bad smell.

THE INNERVATION AND BLOOD SUPPLY OF THE PENIS

The main nerves controlling the penile function and bringing sensual stimuli from the penis are the dorsal penile nerves, situated on both sides in the connective tissue of the upper side of the penis and branching out to all parts of the penis. Erection is controlled by sensual stimuli going to the spinal cord and control impulses coming back, both through this nerve. Ejaculation is controlled by other nerves going to the muscle sheet in the perineum and to all other structures involved in bringing the semen out.

The main blood supply of the penis comes from the dorsal penile arteries going in the connective tissue at the upper side of the penis and branching off to all parts of the penile skin and inner penile structures.

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Many men are worried about the size of their penis and often ask the question “How big should my penis be?” in online communities. This is partially due to the culture we live in, where extra large always means better, and partially due to the fact that women are more likely to have repeated sex with men with larger “tools.” Generally speaking, the penis should be between seven and eight inches. If it is smaller or larger, chances are that women are not going to enjoy having sex as much as they should.

A number of researches have been conducted, and the results are very controversial. There is no concrete answer that men who ask how big should my penis be can be given. For the most part, the average male size is around 6 inches, give or take a quarter of an inch. This means that these men will need only a slight improvement in order to score points with the ladies. There is a large selection of male enhancement products that are available on the market today. Some of these products are scams, others work, and there are a few that are bad for the health.

If you have made a decision to try a penis enlargement product, you should consider a few things. First of all, the product you will end up purchasing should be safe. If you decide to try taking pills, they should be herbal, in order to combine efficiency and safety. One brand of such pills is Extagen, and they come with a 120 day money back guarantee. Another way that you can increase the size of your penis is by doing specific exercises.

How big should my penis be is a question that many men ask. If a person is not satisfied with his size there are a number of non-surgical solutions that he can rely on. The most popular ones are exercises and pills, created from natural ingredients.

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Have you ever watched a commercial for a pharmaceutical product on TV? Whatever ailment is being treated, the actors always change from stuffed-up, in pain and aggravated at the beginning of the ad, to calm, cool and cured by the time it’s over. But, just before the commercial ends, there is either a really fast-talking voice, or a really hard-to-read block of text, that tells you about the side effects. The marketing gurus at So-and-so Company try and pass these off without you even noticing. If you are considering taking Extagen as a male enhancement product, rest easy because Extagen has no harmful side effects. Minor side effects are reported by a small number of users, and these possible side effects are not out of the ordinary, in fact they are common to people who have a hard time taking herbal supplements.

What is Extagen? It’s an over-the-counter capsule that is made of all-natural herbs and phyto-nutrients. When combined, this trademarked mixture increases blood-flow to the penis during sexual arousal. This leads to bigger, harder, and longer-lasting erections. Extagen may also induce a higher libido and more sexual stamina. Results are usually seen in two to five weeks. Many users see up to a one inch increase in penis-size. You need only take one Extagen capsule a day, so it won’t disrupt your busy lifestyle. If you’re not satisfied for some reason, Extagen comes with a 120-day money-back-guarantee (including the cost of shipping).

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In the clinical observation of a newborn, the assessment of the general body appearance of the child such as posture, behavior, Head of the child, Eyes, Nose, Mouth, Neck, Ears, chest region and Abdomen are very essential. But we have to take note that even the assessment of the genitals and Anus are equally very important. So how can this be done and what are the possible features to take note of?

Female genital

Normally, the labia minora and clitoris are edematous, especially following a breech delivery. however, the labia and clitoris must be carefully inspected to identify any evidence of ambiguous genitalia. Normally in a female the Urethral opening is located behind the clitoris. Any deviation from this may suggest that the clitoris may mistakenly be identified as a small penis, which can occur in conditions such as adrenal hyperplasia.

A hymenal tag is usually visible from the posterior opening of the vagina. It is comprised of tissue from the hymen and the labia minora. It usually disappears in several weeks, Generally, the vaginal vault is not inspected, However, absence of the hymenal tag may indicate vaginal agenesis, and in this case further examination would be warranted.

Vaginal discharge may be noted during the first week of life. This pseudo-menstruation is a manifestation of the abrupt decrease of maternal hormones and usually disappears by 2 to 4 weeks. Fecal discharge from the vaginal opening indicates a recto-vaginal fistula and is always reported. Vernix caseosa may be present in large amounts between the labia.

Male genital

The penis is inspected for the location of the urethral opening, which is located at the tip. However, the opening may be totally covered by the prepuce, or foreskin. which covers the glans penis. A tight prepuce is a very common finding in the newborn smegma, a white cheesy substance, is commonly found around the glans penis. under the foreskin. An erection is not uncommon in the newborn. Small, white firm lesions called epithelial pearls may be seen as the tip of the prepuce.

The scrotum may be large, edematous, and pendulous in the full-term neonate, especially in the infant born in breech position. It is more deeply pigmented in dark-skinned races. A non-communicating hydrocele commonly occurs unilaterally and disappears within a few months. The tests should always be palpated for in the scrotum. In small newborns, particularly premature infants, the testes may be palpable within the inguinal canal. Absence of the testes may also be a sign of ambiguous genitals, especially in addition to presence of a small scrotum and penis. Inguinal hernias may or may not be manifested immediately after birth. Identification of a hernia is facilitated by examination when the infant is crying.

Back and anus

With the infant prone, the spine is inspected. The shape of the spine should be gently rounded, with none of the characteristic S-shaped curves seen later in life. Any abnormal openings or masses are noted. A large, protruding sac anywhere along the spine, but most commonly in the sacral area, indicates some type of spina bifida. A small sinus, which may or may not be communicating with the spine, is a pilonidal sinus. It is frequently covered with a tuft of hair. Although it may have no pathologic significance, it may indicate the existence of spina bifida occulta or be a portal of entry into the spinal column. With the infant still prone, symmetry of the gluteal folds is carefully noted. Any evidence of asymmetry is reported, and tests for congenital hip dislocation are performed.

Passage of meconium during the first 24 to 48 hours of life indicates anal patency. If an imperforate anus is suspected, a rectal thermometer or a rubber catheter should be inserted into the anal opening. If a thermometer is used, care must be exercised in order to avoid mucosa perforation. With the infant still prone, the buttocks should gently be separated to inspect the anal area for presence of fissures, or small cracks in the mucosa. Anal fissures are a common cause of constipation because the infant refuses to strain during defecation in order to avoid pain. Asymmetry of the mucosa folds around the sphincter is also suggestive of fissures.

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