A Rare Variation in the Origin and Course of the Artery of Penis

Vascular variations of the penis are very rare. Awareness of its variations is of utmost importance to the urologists and radiologist dealing with the reconstruction or transplants of penis, erectile dysfunctions, and priapism. We report an extremely rare variation of the artery of the penis and discuss its clinical importance. The artery of the penis arose from a common arterial trunk from the left internal iliac artery. The common trunk also gave origin to the obturator and inferior vesical arteries. The artery of the penis coursed forward in the pelvis above the pelvic diaphragm and divided into deep and dorsal arteries of the penis just below the pubic symphysis. The internal pudendal artery was small and supplied the anal canal and musculature of the perineum. It also gave an artery to the bulb of the penis. 1. Introduction The artery of the penis is the distal continuation of the internal pudendal artery after the origin of its perineal branch. It runs anteriorly below or above the inferior fascia of urogenital diaphragm to reach the area just below the inferior pubic ligament, where it terminates by dividing into deep and dorsal arteries of the penis [1]. Artery of the penis may rarely arise directly from the internal iliac artery and continue as the deep artery of the penis when the dorsal artery of the penis is a branch of internal iliac artery or the inferior epigastric artery [2]. Knowledge of variations in the origin and course of the artery of the penis is important to radiologists, surgeons, and urologists. We report an extremely rare variation of the artery of the penis and to the best of our knowledge this is the first report on such a variation. The clinical and surgical implication of the variation is discussed. 2. Case Report During dissection classes for undergraduate medical students, a rare variation in the origin and course of the artery of the penis was noted. The variation was found in an adult male cadaver aged approximately 70 years. The left internal iliac artery did not divide into anterior and posterior divisions. The main trunk of the internal iliac artery gave iliolumbar, lateral sacral, superior gluteal, middle rectal, and superior vesical arteries. In addition to these arteries two common trunks arose from it. The first common trunk bifurcated into inferior gluteal and internal pudendal arteries, whereas the second common trunk gave two inferior vesical arteries, obturator artery, and the artery of penis (Figure 1). The artery of the penis coursed forwards between the bladder and lateral pelvic wall until the pubis.