Vascular tissue, with the vascularity being less prominent compared to the underlying corpus spongiosum. The coronal sulcus lamina propria is essentially a prolongation of the foreskin and glans lamina propria.
The foreskin, or prepuce, is a mixture of skin and mucosa that is basically an extension of the skin of the shaft and normally covers most of the glans, with an inner mucosal surface of the foreskin covering the coronal sulcus and glans surface (13,14). Grossly, the skin surface is dark and wrinkled while the opposite mucosal lining exhibits a pink to tan coloration.
Histologically, there are five layers to the foreskin: the epidermis, dermis, Dartos, lamina propria, and epithelium. The skin is made up of epidermis with keratinized stratified squamous epithelium and dermis with connective tissue containing blood vessels, nerve endings, Meissner (touch), and Vater-Panini (deep pressure and vibration) corpuscles, with a few hair structures and sebaceous and sweat glands. The Dartos is the middle component of the foreskin and has smooth muscle fibers surrounded by elastic fibers, with numerous nerve endings. The lamina propria is a loose fibrovascular and connective tissue with free nerve endings and genital corpuscles. The squamous epithelium of the mucosa surface of the foreskin is in continuity with the glands and coronal sulcus mucosal epithelium and is the same structurally. The skin of the penile shaft overlies the Dartos, Buck’s fascia, tunica albuginea, corpora cavernosa, and corpus spongiosum (Fig. 1.5). It is rugged and elastic and comprises an epidermis and dermis. The epidermis is thin, with slight keratinization and basal layer pigmentation. Hair follicles are present and are more frequent in the proximal shaft. Only a few sebaceous and sweat glands can be found.
Lymphatics of the glans drain into superficial and deep inguinal lymph nodes, whereas lymphatics of the foreskin and skin of the shaft drain into superficial inguinal nodes (14). The blood supply of the skin is supplied by external pudendal blood vessels (15). Venous blood of penile skin flows into a subdermal venous plexus, which drains into several veins at the base of the penis (15). Innervations of the glans and foreskin are by terminal branches of the dorsal nerve of the penis (13).
Skin of the scrotum is pigmented, hair-bearing, and loose with numerous sebaceous and sweat glands. Depending on patient age and tone of the underlying smooth muscle, the surface is smooth to highly folded and wrinkled, with transverse rugae. The epidermis is thin, and along with the dermis, overlies the Dartos layer of smooth muscle. A subcutaneous fat (adipose) layer is lacking. The anterior scrotum is supplied by the external pudendal blood vessels and the posterior scrotum is supplied by the internal pudendal blood vessels (15). Venous drainage for anterior scrotum is via the anterior scrotal subdermal venous plexus that converges at the neck of the scrotum to join the external pudendal vein. The subdermal venous plexus of the posterior scrotal wall drains into the perineal vein to join the internal pudendal vein (15). Lymphatic drainage is to the superficial inguinal lymph nodes. The scrotum has a complex pattern of innervation (16). The main supply is via scrotal branches of the perineal nerve, a branch of the pudendal nerve. Other contributions come from the inferior pudendal branch of the femoral cutaneous nerve and the genital branch of genitofemoral nerve and anterior cutaneous branches of the iliohypogastric and ilioinguinal nerves (16).
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