Pudendal nerve in the context of "Anal sex"

Hard flaccid syndrome (HFS), also known as hard flaccid (HF), is a rare acquired dysautonomic condition characterized by a flaccid penis that remains in a firm, semi-rigid state in the absence of sexual arousal. Patients often describe their flaccid penis as firm to the touch, rubbery, shrunken, and retracted, frequently accompanied by pain, discomfort, and various other symptoms. While the condition is not fully understood, current research indicates that HFS results from excessive sympathetic nervous system activity in the smooth muscle tissue of the penis, triggered by a pathological activation of a proposed pelvic/pudendal-hypogastric reflex. Among other causes, injuries to the erect penis, blunt trauma to the pelvis or perineum, and damage to the cauda equina are thought to induce this reflex. Although unproven, axon sprouting in sympathetic ganglia following a peripheral nerve injury is a possible explanation for HFS. The majority of patients are in their 20s and 30s, with symptoms severely affecting their quality of life. Treatment typically involves a combination of alpha blockers and PDE5 inhibitors, although there is limited evidence supporting their efficacy. Due to the lack of comprehensive understanding and awareness within the scientific and medical communities, there is currently no definitive treatment for HFS.

In mammals, the vulva (pl.: vulvas or vulvae) comprises mostly external, visible structures of the female genitalia leading into the interior of the female reproductive tract. For humans, it includes the mons pubis, labia majora, labia minora, clitoris, vestibule, urinary meatus, vaginal introitus, hymen, and openings of the vestibular glands (Bartholin's and Skene's). The folds of the outer and inner labia provide a double layer of protection for the vagina (which leads to the uterus). While the vagina is a separate part of the anatomy, colloquially the term has often been used synonymously with vulva. Pelvic floor muscles support the structures of the vulva. Other muscles of the urogenital triangle also give support.

Blood supply to the vulva comes from the three pudendal arteries. The internal pudendal veins give drainage. Afferent lymph vessels carry lymph away from the vulva to the inguinal lymph nodes. The nerves that supply the vulva are the pudendal nerve, perineal nerve, ilioinguinal nerve and their branches. Blood and nerve supply to the vulva contribute to the stages of sexual arousal that are helpful in the reproduction process.

The urethral sphincters are two muscles used to control the exit of urine in the urinary bladder through the urethra. The two muscles are either the male or female external urethral sphincter and the internal urethral sphincter. When either of these muscles contracts, the urethra is sealed shut.

The external urethral sphincter originates at the ischiopubic ramus and inserts into the intermeshing muscle fibers from the other side. It is controlled by the deep perineal branch of the pudendal nerve. Activity in the nerve fibers constricts the urethra.

The bulbospongiosus muscles (in older texts accelatores urinae, bulbocavernosus and, for female muscle, constrictor cunni) are a subgroup of the superficial muscles of the perineum. They have a slightly different origin, insertion and function in male and female mammals. In human males, these muscles cover the bulb of the penis, while in females, they cover the vestibular bulbs.

In both sexes, they are innervated by the deep or muscular branch of the perineal nerve, which is a branch of the pudendal nerve.

The internal pudendal veins (internal pudic veins) are a set of veins in the pelvis. They are the venae comitantes of the internal pudendal artery. Internal pudendal veins are enclosed by pudendal canal, with internal pudendal artery and pudendal nerve.

They begin in the deep veins of the scrotum and of the penis, issuing from the bulb of the vestibule and the bulb of the penis, respectively. They accompany the internal pudendal artery, and unite to form a single vessel, which ends in the internal iliac vein.

The perineal nerve is a nerve of the pelvis. It arises from the pudendal nerve in the pudendal canal. It gives superficial branches to the skin, and a deep branch to muscles. It supplies the skin and muscles of the perineum. Its latency is tested with electrodes.