As with many areas of the body, it is good to know about the cardiovascular system because of the important contribution it plays in bodily function.
When engaged in kink activities, having even a rough understanding of where the arteries and veins of the body are can make a tremendous difference in the comfort and well being of the bottom. If you are playing with knives or any kind of blood play, this information becomes increasingly important or even if you are simply doing some bondage, this information can reduce the chance of constricted blood flow that can lead to numbness or unwanted discomfort.
What is the Cardiovascular System?
The cardiovascular system is made up of your heart, blood and blood vessels. This system uses your blood to deliver oxygen and nutrients to every area of your body as well as pick up waste products for disposal (Discovery Communications Inc, 2000).
Your blood pumps through two different channels: arteries or veins. Arteries are broad-walled tubes that are covered by yellow elastic fibers. The elastic fibers are filled with muscles that absorb the pressure waves from your heartbeat and slows your blood flow down; this pressure is commonly known as your pulse. Veins, in contrast, have thin and slack walls since your blood has already lost the pressure from your heartbeat and carries your deoxygenated blood back to your heart (HowToMedia, 1999).
Your Heart
While we have many sentimental ideas about our hearts and we know that they are vital to our survival, when you get right down to it the heart is an elaborate and complex pump (Bianco, 1998).
In the average lifetime, a heart beats over two and a half billion times and experiences no rest breaks (The Franklin Institute, 1996). The sound of your heartbeat is caused by the acceleration and deceleration of your blood as it moves through the various sections of this crucial organ (Bianco, 1998).
The heart is comprised of three layers: endocardium, myocardium, and pericardium. The endocardium is the inside lining of the heart while the myocardium is the middle layer. The pericardium is a fluid filled sac that surrounds the exterior (Bianco, 1998). Once inside the heart, this organ has four open spaces, or cavities, that your blood moves through; two of the cavities are atria while the other two are ventricles. The atria are the cavities that comprise the top curved portion of the heart and the ventricles form the bottom portion (The Franklin Institute, 1996).
Each cavity has a type of one-way valve which connects to the next section that keeps your blood from flowing backwards through your heart. When the cavity or chamber contracts, this valve exit opens and allows blood to move into the next heart cavity, closing the valve with the end of the muscle contraction so that the blood does not move back (Bianco, 1998).
Your heart pumps due to a specialized group of cells that are able to produce electrical activity independently. The heart has a natural pacemaker called the sinoatrial node which is located in the right atrium. This node conducts electrical impulses to the rest of the heart through unique fibers. The cells divide charged particles and then spontaneously release some charged particles into selected cells. This action occurs multiple times per second to cause an electrical impulse to spread over the heart and force it to contract to produce a normal heart beat of 72 beats a minute (Bianco, 1998).
Infant circumcision is made more acceptable by believing the notion that there is a flap of skin at the end of the penis called the foreskin which hangs over the glans and circumcision simply removes that flap. This is factually incorrect. By thinking that the foreskin is separate or “extra” tissue it is easier to believe that its removal does little to impact or change the rest of the skin of the penis.
There is really no separate anatomical structure called the foreskin. Rather there is one single continuous skin sheath of the penis which is called the skin system. This single, uninterrupted skin sheath may, at any given time, fold to varying degrees over the glans or retract to reveal it. The amount of the skin system that is folded over can be referred to as the forefold of the skin system. Its extent changes often to accommodate degrees of erection, and it is never a separate structure from the skin of the shaft.
What the operation called circumcision actually does then is to interrupt and significantly reduce the skin system of the penis to a fraction of its normal anatomical and functional extent.
The skin system of the penis
The intact penis is covered by one single continuous skin sheath or skin system. The skin sheath is partly folded at different times. This folded part of the skin system is called the foreskin or prepuce.
The fold of skin is often mistaken as a single layer, or a flap of skin. This is wrong. Instead, it is a free, two-layer fold that forms when the skin coming down the penis from the shaft folds underneath itself somewhere near the tip of the penis then travels back to an attachment point behind the glans (see figures 6 and 4). The two sides of the fold do not adhere to each other even though they lie flat against each other appearing to form a single flap of skin.
Also, in the adult the skin system does not adhere to the glans so it can unfold back off of the glans, leaving it fully exposed. When we speak of this skin sheath we are not talking about the surface of the glans itself in the same way that we talk about the surface of the shaft, because the glans has no real skin. When we talk about the skin covering of the glans, this can only mean the foreskin. The foreskin is its skin covering.
The fictitious foreskin
A significant anatomical error has been made historically and continues today in describing the penis by delineating the “foreskin” as a separate anatomical structure from the shaft skin. People talk about the “foreskin” separately from the shaft skin. This is a mistake. It is not correct.
The foreskin is not a separate anatomical structure from the rest of the skin of the penis. This is actually an artificial separation. When the word foreskin is used, rather than referring to a separate part of the penis, it means the part of the continuous skin system which happens to be folded over the glans at any given time. So there is no real anatomical border to the “foreskin.” Since the proportion of the skin system that is folded over the glans increases and decreases by folding and unfolding to various degrees all the time, we realize that “foreskin” is a poor way of describing the anatomy of the penis. Instead, more accurate terminology might be to describe that part of the skin system which covers the glans as the “forefold of the skin system.”
Unlike the false border between “foreskin” and shaft skin, there is a real anatomical border which exists in the skin system. It is between the mucosal, or non-keratinized, part of the skin system (which consists of the inner lining of the foreskin along with the surface of the glans) and the keratinized part (which is the outer penile skin, including the outer foreskin). That border is at the most distal part, or tip, of the skin system - it is the tip of the forefold (see figures 6 and 7).
The mobility of the skin system
The entire skin system moves freely. In the intact (uncircumcised) male, the penis has a low friction gliding plane immediately beneath the surface of the skin which is like no other body structure. This means that the skin of the penis does not adhere to the underlying tissue the way that skin adheres to other parts of the body. This unique quality allows the entire skin of the penis to move as a unit back and forth longitudinally or around the shaft circumferentially making it the most mobile skin in the intact male.
The skin system covers the head of the penis to varying degrees depending on moment-to-moment factors such as the state of erection and temperature. The free fold of the skin system which we call “foreskin” unfolds and re-folds constantly to varying degrees, adjusting to the current state of the penis. It is a very dynamic system. The foreskin, among other functions, provides the penis with a reservoir of skin which is needed during erection. The skin of the erect, intact penis is still mobile and loose, allowing the mucosal inner foreskin to roll back and forth over the glans (see figure 7).
Thus, the dividing line between what we call the skin of the shaft and foreskin is regularly crossed by the “shaft skin” or “foreskin.” The delineated “foreskin” may become entirely “shaft skin” when the penis becomes more erect because it is now around the shaft. And if the penis shrinks momentarily beyond its usual flaccid state, perhaps due to a cold swim at the beach, some of the “shaft skin” is now “foreskin” because it covers the glans. The skin system is a dynamic, mobile and flexible skin sheath that moves and adjusts to the momentary needs of the penis (see figure 7). Such a system is not normally observed in the circumcised male.
Another anatomical error is committed in describing the foreskin as a flap of skin protruding from the shaft skin (figure 6a). This notion presumes that the foreskin is a single layer of skin, like the skin of the shaft, which grows from the shaft to cover the glans. In describing the foreskin this way it is easier to see it as redundant or “extra skin” and it is more difficult to see how removing it might impact the rest of the penis. This description of the foreskin is inaccurate. The foreskin is not “extra” skin which protrudes from the shaft. There is no extra skin on the body - this is a silly notion. Instead, it is a free, double-layered fold - an integral part of the skin system. The foreskin extends from a point on the shaft behind the glans to cover the glans then folds back underneath itself to the same attachment point on the shaft, usually near the glans (see figure 6). The eyelid works much the same way. The eye lid is not a single flap of skin, but rather two freely moving layers of a fold of skin, so that both the foreskin and the eyelid have two layers. That’s why it is more appropriate to refer to the “foreskin” as the forefold of the skin system.
In reality then, infant circumcision does not remove the “tip of the penis” or “redundant skin” nor does it remove a separate structure called “the foreskin.” Rather, infant circumcision deletes a significant percentage of the skin system of the penis, rendering the skin system relatively dysfunctional and rendering the penis less dynamic.
The “triple whammy”
The circumcised penis loses sensitivity in three ways:
Loss of the foreskin nerves themselves. As has been demonstrated by studies such as the one by Dr. Taylor and by the testimonials of the majority of intact men, the inner foreskin possesses a greater density of nerve endings. It is thought to be more erogenous than even the glans. The is no question that the foreskin is a highly erogenous tissue. This tremendous amount of sensitivity is lost completely when the forefold of the skin system is amputated. In addition to this, the most sensitive part of the penis, the frenulum of the foreskin, is either partially or totally removed in most infant circumcisions. The frenulum is the continuation of the inner foreskin which attaches to the underside (ventral part) of the glans. Thus, a significant percentage, if not the majority, of erogenous nerve supply to the penis is removed in circumcision at birth.
Damage to the glans. The erogenous sensitivity that remains after circumcision is primarily in the glans. This is further reduced by removal of the protective foreskin which leaves the glans permanently exposed. Unlike the shaft of the penis, and most of the rest of the body, the head of the penis, does not posses its own attached skin. This structure, like the eye ball and the gums of the mouth, is a somewhat naked structure. Its surface is non-keratinized, like that of the gums, the eye ball, and the clitoris in women. That means that it does not posses a protective thick layer like the keratinized skin of the outer penile skin system. Like the gums and the eye ball, the glans of the intact penis has a retractible skin covering. The skin covering of the glans is the foreskin. The eyelid is very similar in architecture to the foreskin. If the eyelid were removed and the eyeball were to become keratinized, you’d have a much harder time seeing. The same is true of the glans. It becomes artificially keratinized (dry, ha rdened, discolored, and wrinkled) as a result of permanent exposure, and thus less sensitive. Because most American men are circumcised and have a glans of this nature, it is harder to notice the abnormality. But just compare the glans of an intact man with that of a circumcised man next to each other and you’ll notice a big difference. Thus, in addition to removing lots of erogenous nerve endings in the inner foreskin and frenulum, circumcision further desensitizes the remaining sensitivity of the glans by leaving it exposed.
Loss of skin mobility. The nerve endings in the glans are predominantly complex touch receptors also known as mechanoreceptors. This is different from the light touch receptors of the skin which detect surface friction. The mechanorecptors are best stimulated by massage action rather than surface friction. Thus, the glans is best stimulated to feel pleasure by a rolling massage action. With an ample and highly mobile skin system that rolls over the glans with pressure from the opposing surface, this optimal stimulation of the glans is achieved while avoiding direct friction of the delicate glans surface. Direct friction tends to fire off pain receptors causing irritation and also causes further keratinization of the glans. With the skin system of the penis significantly reduced by circumcision, the mobility is essentially gone and now the penis is a static mass with no dynamic self stimulation mechanism. Now, it must be rubbed. Direct friction is now the primary form of stimulation. So then circumcision further reduces erogenous sensitivity in the penis by reducing skin mobility and thus the ability to use the foreskin to massage the glans. The combination of foreskin and glans in concert results in an even higher level of stimulation which is unknown to the circumcised male.
Conclusion
Circumcision of an infant male significantly reduces erogenous pleasure potential in his penis when he becomes sexually active and continues to be reduced as he ages until, in many cases, he is left with relatively little sensation.
Adult Circumcision vs. Infant Circumcision
A common misperception is that infant circumcision is preferable to adult circumcision because it spares a man pain and trauma. Many physicians however say the opposite and critics admit that most of their objections to infant circumcision cannot be applied to the adult procedure. Here’s why:
More precise with better outcome. Circumcision of an adult can be more precise and less risky than for the infant. This is because the adult penis is fully formed. Many plastic surgeons operate on the penis in the erect state because this way it is clear to what extent the skin is stretched during erection. In the infant, this more precise method cannot be employed. Also, based on the knowledge of his own penis, the adult patient can specify how much tissue to remove, the infant cannot. In terms of how much tissue to remove, there is much more guess work involved in the infant and often too much skin is removed. In adult circumcision precise instruments are used. In the infant, usually more cumbersome and less precise instruments like the Gomco clamp are used. The results of operating on a fully formed penis, in the erect state, with precise instruments by a trained surgeon, benefit the adult and not the infant.
Reduced risk of injury. For the same reasons mentioned above, injury to the penis is less likely in adult circumcision than in infant circumcision. It is less likely that too much or too little tissue will be removed and the chances of lacerating the glans itself are also minimized. Scarring is also reduced in the adult.
Reduced loss of sensitivity. Because in the adult, the penis has had many years to develop with a foreskin covering, the glans is fully sensitive at the time of the circumcision. The glans has grown with its protective covering and the foreskin has already separated naturally from the glans. This spares the adult some of the sensitivity loss that occurs when circumcision is performed at birth. At birth, the foreskin must be torn away from the glans to which it is normally adhered. Then, the denuded glans of the infant spends much time exposed to caustic urine while in diapers. In adult circumcision this early damage to the glans is avoided.
Personal choice. With adult circumcision the patient is making a personal choice to have himself circumcised. He has the option of comparing the pros and cons and has had the opportunity to know what having a foreskin is like. This eliminates the “lack of choice” objection made by critics. With elected adult circumcision, critics see no violation of rights.
Reduced potential psychological effects. With adult circumcision potential psychological effects are reduced. This is because the patient understands the experience. He knows why it is happening and that he has chosen this. Anesthesia is used in the adult and is usually omitted or ineffective in the infant. In contrast, the infant has an experience of inexplicable pain and terror which he cannot rationalize as an adult. Some speculate that this intensely painful experience for the infant can lead to problems later on. Although on the surface it may seem that an infant is less sensitive to or unaware of the circumcision experience, he does experience it fully and because of his very formative and psychologically sensitive age, the experience is thought to be potentially more impacting than it is for the adult.
Making love to another man is a subject not covered very much in the bookshops of the world. There are plenty of books on how to please a woman but when it comes to our own sex, we have to find out by practice and experience.
I have enjoyed sex with other men for more years than I like to think about. The starting point is always, what do I like another man doing to my body. There is one problem with this, we all like different things. So kiss my tits and I’ll jump off the bed but do it to some guys and they will just wonder what you are doing.
However kiss the same guy on the neck or nibble his ear lobes and he’ll grip you tight and beg for more. It is possible to identify the hot zones of the male body a fair number of which will excite the average guy.
One interesting fact based on my own experience is that even if a guy claims to be straight, if you can get to the point where you have access to a few of these zones, he will forget his claimed sexuality pretty quickly.
The photograph below shows at least twelve zones which will excite your man if you approach them properly. Study it for a few minutes and think which zones turn you on.
Zone one is the neck
Few men can resist the soft touch or light finger tips touching here. Perhaps this is one reason for the vampire legends. Exposing your neck as the model is doing, suggests a vulnerability. Use the tip of your tongue to begin with, searching for the areas which produce the greatest effect. The side is usually more sensitive than the front or back although the nape of the neck can be ultra sensitive in some men.
Zone two
The nipples, vary more than any other part of the body. Some guys don’t seem to have any feeling there at all but others, including myself, have intense feelings. There are many techniques with nipples. Feather like touches with the tip of the tongue, running it round the outside before touching the centre will cause the nipple to harden. As it hardens the sensitivity increases. Some guys will, myself included, jump if their nipples are touched lightly but react less to a firmer touch.
Moving on you should then try enclosing the whole nipple with your mouth and continue to use the tongue, moving it in a circular movement. This is very effective when combining using the hands to touch other zones such as the neck. Many guys can be made to come with just this technique and nothing else except using the hand on the penis. Use the hands on the nipples and chest area as well manipulation of the breasts is enjoyed by most guys.
Zone three
This leads on the shoulder area. Suprisingly under the arms can be very sensitive and kissing here can produce immediate reactions. Hopefully your partner is well showered and fresh smelling, but fresh sweat with it’s slightly musky odour can also be a turn on. Many guys now shave under their arms and the exposed skin can be very sensitive to touch by a wet tongue.
The front chest area and shoulders respond well to manipulation with the hands using a fairly firm pressure and circular movements. One partner of mine would enjoy this for ever if I didn’t finally have to stop as my hands ached.
Zone four
Is the back. This is where virtually every man loves being touched. The top shoulders can be massaged using the hands and supplemented with oils but use the mouth as well. Explore the back with the tongue, there are lots of variation across this wonderful part of the male body with oasis’s of feeling waiting to be found. Personally I love having a guy with stubble rubbing my back with his cheek. It gives me intense, hard erections instantly. I have had partners who also enjoy the feeling of a hair brush rubbed lightly over the back.
The lower part of the back is also very sensitive and the waist area where is curves round to the front is great to suck and kiss.
If you do use oil on the back, take care if you later use condoms. Oil can damage the rubber.
Zone five
Is the area of the waist on the left and right of the front of the body moving down to the top of the legs. One of the most sensitive spots on the body is often found here in the groin and some guys find it so stimulating they can hardly stand being touched there. use the mouth to explore, softly kissing and using the tongue, noticing how your partner is responding.
Zone six
Brings us to the balls. Myself, I don’t enjoy being touched too much here but many guys love it and you can pop them in your mouth, lick them, massage them quite roughly and they will love it. Don’t neglect the area behind the balls where the shaft of the penis disappears into the body.
On some guys it’s almost an extension of the penis and rock hard and standing out from the body. On others it is less prominent but the area is still sensitive with the prostrate gland underneath the skin.
The extreme top of the legs can also be very sensitive and many men love having their legs wide open and the whole area being virtually chewed by their partner’s mouth. It is very popular in a 69 position with your partner doing the same to you.
Zone seven
Is the ‘tummy button’ Strange part of the body this, my own is totally dead with no feeling but I’ve met guys who go wild when a tongue explores the area. Don’t neglect it, try it on your partner as see what happens.
Zone eight
Takes us back to the head and the area around the eyes. Although not very sensitive, It is suprising how many guys like closing their eyes and then having their partner gently kiss eye lids, perhaps running the tongue along the area under the eye brows. The forehead is also an area some guys like their partner touching, either by gentle stoking with the fingers or with the tip of the tongue.
Zone nine
Is the mouth. Now we are into kissing and this is a great turn on for most guys. The idea of kissing another man seems to be a big hang-up for some straight men especially the homophobic, but come on, it’s great. there are still so called gay men who specify 'no kissing’ What they are afraid of is that kissing opens up all kinds of emotions in the body. It sets all kinds of hormones flowing in the body and if you want to stay totally in control of what you are doing sexually it is very dangerous.
Kissing shows a willingness to submit to another man sexually in a deeper way than a quick blow job or a hand job. It is symbolic that when two men kiss, they are moving into a different kind of man to man sex. However, you don’t have to be deeply in love to kiss. Kissing passionately a total stranger on a one night stand can add excitement to a casual encounter but doesn’t mean you are planning a lifetime together. Some guys don’t understand this.
Zone ten
We return to the legs. Most guys neglect them, concentrating too long on the top and middle. The inside thighs on many guys can send shivers through their bodies when touched. If they are muscular just touching is a turn on for the person touching as well. Rugby player legs are in great demand ! Go right down the legs to the feet. Foot massage is very soothing and even royalty enjoys a bit of toe nibbling. Don’t neglect the back of the knees
Zone eleven
The anal area was described by Boy George as the gay spot. Not every gay man likes being penetrated although too often they haven’t tried or have suffered from attempts by guys who don’t know what they are doing. But every guy I have ever met likes to be touched in that area. being touched can range from just allowing a finger to gently touch the outside in a circular movement, perhaps using a little lubricant.
One long standing partner loves being touched here as he comes, claiming it intensifies the feeling many times over. Inserting the finger into the anus using KY or similar lubricant is also enjoyed by many gay men who don’t want to go ’ all the way’ From my experience, bi guys and straight guys also love it once they overcome their heterosexual indoctrination. Inside, the finger can explore for sensitive spots including the prostrate gland.
Some guys go further and can get a whole fist up inside. Personally that isn’t on for me and I would consider it possibly dangerous but I mention it as some guys do get turned on that way.
Fucking of course comes under the stimulation of zone eleven and the technique of fucking could fill a book. The penis has to get past a ring of muscle which can be painful but only for a second or two and once entry is achieved, the person being fucked can enjoy the ultimate sexual stimulation.
Part of the feeling is without doubt mental, giving your body up to another man, being submissive to another man. But it isn’t just that. It is total relaxation ( one of the reasons one’s own penis looses it’s erection much of the time, and watching the expression on the partners face as he uses your body for his enjoyment building up to the moment when he comes, is a real turn on.
Zone twelve
Which is jumping the gun a little, as we haven’t talked about zone twelve, the dick, cock, penis, willy, whatever you want to call it. A miracle of sensitivity. It comes in two flavours, cut and uncut and a variety of shapes and sizes. Controversy will always rage about cut or uncut and which is best. I’ll declare an interest. I am cut. Why I don’t know, I’m British, not a Jew or Muslim. It has never stopped me enjoying sex and the end is much larger in proportion to the shaft than in most uncut guys I’ve come across. maybe removing the skin allow it to grow larger. I’ve noticed this with many guys cut as babies.
Uncut is fine as long as the guy washes himself properly, if he doesn’t, he’s probably not gay. He does have an advantage in masturbation, using the covering with it’s inbuilt lubrication to stimulate himself. We cut guys need baby oil or whatever come to hand, as it were. Some guys claim uncut guys come too quickly as the head of the penis is more sensitive. I cannot say I have experienced that but I do find the shape of an cut penis more exciting unless the uncut guy has a foreskin which pulls right back when he is hard.
Stimulating the penis during sex can be oral using the tongue or the the whole mouth. With the tongue, start at the tip and then run it round the head paying attention to the 'join along the back. Using the hand at the same time on the shaft increases the pleasure. Taking the head of the penis in the mouth and continuing to use the tongue and hand should get your partner rock hard and then taking in as much as the shaft as you can swallow without gagging should increase the excitement to fever pitch.
The male body is like a musical instrument but like a musical instrument we have to learn to play it. The bad thing about sex is that so few men learn. For too many guys straight and gay, getting and erection as quickly as possible and coming is what sex is all about. Skilled partners can make sex wonderful. So start practising now and see how your sex life improves.
Maybe one day in an elightened world sex lessons in schools will concentrate on pleasing a partner rather than going on about contraception,disease, rabbits, birds and bees and we will stop seeing sex as dirty and something to get over as quicky as possible.
A FEW DO AND DON'TS
Making love to another human being is one of the most intimate acts any of us indulge in, one of the most natural and probably the most pleasurable.
But most of us are turned off when our partner suffers from stale body odour, bad breath or a neglect of simple hygene.
We don’t have to douse ourselves in the latest Calvin Klein aftershave to smell good, natural body odour can be a turn on when it is fresh but a shower before sex (and after) does give the skin a fresh smell and feel. Bad breath can be due to lots of causes but if you suffer, there are sprays or tablets you can use shortly before a session. Long term a visit to a dentist, change in diet or cutting out smoking might help.
Washing your dick before sex is a must especially if you are not circumcised. Nothing is worse than pulling back the foreskin and finding something nasty lurking. It may be natural but it sure turns most guys off.
Some guys like to remove some or all of the hair around their dick and balls. If the rest of your body is hairy it can look silly but on an otherwise smooth guy it can make the dick look larger. Cutting the pubic hair back a bit is OK and perhaps removing the hair of the balls using Immac or similar products can give them a nice silky feel.
Watch out if you use baby oil. If it gets onto condoms it can cause them to tear. If you are going to use condoms, stay clear of the oil. Use KY or similar water based products. Afterwards if you fancy a massage, then use the oil by all means.
Oh yes, one last thing, even if your feet feel cold, removing your socks before sex is advised.
We tend to forget that the production of reproductive cells is a costly effort in terms of both resources and energy. Because of this, an event called orgasm appeared and evolved over time as a way to control when semen should be expelled. This trigger, the orgasm, ensured that semen wouldn’t be wasted uselessly.
Despite this, Nature still needs that the male sperm be dispensed easily. Making it too difficult could impede the successful reproduction of species. For this reason, evolutionary selection has insured that males could be easily prodded towards orgasm in order to obtain the precious seeds whenever an un-impregnated female would be around.
The male orgasm thus exist for a purpose, and this purpose is ejaculation. From the reproduction’s purposeful point of view, there is no use for multiple orgasms in the male : once he’s been brought to an orgasm, by design he has also ejaculated. And once this ejaculation has occurred, the male’s storage of seed is (temporarily) depleted. Nature is not interested in promoting useless orgasms because it would decrease the likelihood of successful reproduction. Hence, after ejaculation, there is a period of unavailability that disqualifies the spent male for an immediate fuck. We humans like to give polite names to things, so we call this fact the refractory period.
In order to enjoy dick effectively, it is essential that you understand some very basic information about the male penis and how it (and the parts around it) works. While it is certainly possible to just stick one in your mouth, bob up and down on it a few times and make it cum, you’ll only be able to do that with inexperienced males. The guys who’ve been around and/or are more wordly are going to want more than that. In fact, they’re going to expect it of anyone who considers themselves a true slut.
Sucking cock is the single most important skill a slut must possess. You will, quite literally, be graded on your ability to suck cock from the very first time you do it. The more you understand about how things work down there for the guys, the better you can perform this task, and the more sexually desirable you become. With that in mind, let’s re-examine some of the basics. If you want a fully detailed explanation of all the pieces and parts and how they work, please see the SLUT103 course. Subsequent modules in this course will explain how to go down on a guy’s cock and achieve the desired end result.
The Basics: Parts and Their Functions
The Penis: The penis, of course, is the central point of focus with respect to this course. It is the external male sex organ, but also serves as the primary path for the evacuation of urine from the body. When sufficiently stimulated, the penis becomes rigid as the result of blood filling the three large tubes that run the length of the penile shaft (these are discussed at length in the A&P course (SLUT103)). This results in the penis becoming stiffer and elongated, generating what you see as an erection. It is important to note that sexual stimulation is not the only thing that can lead to an erection. Any kind of physical stimulation will generate an erection in most men, as will certain physiological responses not associated with sex. So though it is a prevalent archetype, the fact a man has an erection does not necessarily mean he is sexually aroused and/or wants to have sex.
The head of the penis is known as the glans. The male glans is the homologue of the glans (visible part) of your clitoris (though with only half the nerve endings). In uncircumcised men, the glans is covered with pink, moist tissue called mucosa. Folded over the glans is the foreskin (prepuce). In circumcised men, the foreskin is surgically removed and the mucosa on the glans transforms into dry skin. The frenulum is the underside of the penis where the head meets the shaft, while the coronal ridge is the rounded projecting border that surrounds the head. The head and frenulum are the two most sensitive spots on the penis. This is an important fact to keep in mind when you start playing with one of these things.
Circumcision used to be a routine procedure for almost every infant in the United States, but over the past couple of decades this procedure has become somewhat less popular. Therefore, with younger men you are slightly more likely to encounter an uncircumcised penis than you would be with older men. They are basically treated the same way for oral sex with some very minor differences which are discussed in a later module. The following photo shows the difference between the cut and uncut penises. The Scrotum: The scrotum is the little sack beneath the penis that holds the man’s testicles. It is known by a variety of monikers, with the most common being “nut sack” or just “sack,” while the testicles inside it are commonly referred to as “balls.” Many men like having their sacks played with while you’re sucking their cocks, but some don’t. Again, more on this in the following module.
There’s a little muscle in the scrotum that is responsible for adjusting the height of the testicles; it is known as the cremaster muscle. When the sack is exposed to coldness (such as cold water in a pool), the muscle pulls the testicles up closer to the body to keep them warm. When they are exposed to heat, such as on a hot day at the beach, the muscle will relax allowing the sack to hang much lower to get the testicles away from the body. The preferred temperature for sperm production is 95F, about three degrees cooler than normal body temperature. This is why the testicles are outside and away from the body to begin with. So on warm days it is easier to play with and suck on that wrinkled little sack than it is on the cold days.
Perineum: The perineum is the area of skin between where the scrotum meets the pelvic floor back to the guy’s asshole. This is also commonly referred to as the “taint” (supposedly derived from the saying that “…it ‘taint the nutsack and it ‘taint the asshole). The measure of the distance between the two is known as the anogenital distance. That’ll come in handy in a trivia game at some point, trust me. Beneath the skin of the taint is the prostate gland, which, as you grow more proficient with your cocksucking skills, may become another source of pleasure for the guy you’re playing with. We’ll also discuss this in a future module as well.
Penis Sizes and Shapes
Every single penis you ever encounter in your life will be different from every other penis you see or encounter. No two penises are alike. They are different lengths, different girths (circumferences), different colors, they have different curves to them, they’re surrounded by different amounts of pubic hair, some will be circumcised and others won’t, etc. How they look is largely irrelevant to how you go down on them, however. Obviously, the bigger they are, the harder it will be to get as much of them in your mouth, but the basics of sucking cock apply regardless of what they look like.
The average size of the erect penis is in the 5.5 to 6.3 inch range, depending on which survey you use. Just about every organization that has something to do with human sexuality, from major universities to condom manufacturers, has done their own surveys on the size of these things, and the average “average” is in that range. Some can be as little as three inches long or smaller, while the largest one ever recorded was over thirteen inches. The average girth (circumference) is around 4.5 to 5.0 inches, but range from anywhere around three inches or so up to over six inches. So as you can see, you’re liable to experience quite the range of penises as you move through your life of slutdom.
Showers vs. Growers
One of the more unique aspects of penises is that, not unlike their erect size, even when they’re flaccid they tend to have their own unique shapes and sizes. You will also find that the size of a penis when it is flaccid has no direct bearing on its size when it is erect. A lot of people are shocked at that and are quick to jump to conclusions the first time they see a guy with a tiny, shriveled up penis when he drops his pants and they get their first look at him. But they are often pleasantly surprised when he becomes erect and it transforms into this massive penis (I’ve always been kind of fond of those types, actually). So the flaccid length has no relevance whatsoever to how big he’s going to be when he’s fully erect. You’ll find that there are basically two types of flaccid penises. What kind you have determines whether you’re a “shower” or a “grower.”
A “shower” (pronounced like grower) has a penis that is disproportionally big when flaccid relative to the final erect length, whereas a “grower” has a penis that is disproportionally small when flaccid relative to the final erect length. In other words, when you see a shower’s penis, what you see is pretty much what you’re going to get when it becomes erect; it’ll get a bit bigger, but not much. With a grower, however, you get quite the surprise when he gets aroused. As the penis becomes erect, it will be substantially larger than its flaccid size. As you might imagine, the growers tend to be a bit more sensitive about the flaccid size of their cocks. As a slut, you’ll want to ensure that you don’t make the mistake of assuming that a smaller flaccid penis is going to automatically be a tiny penis when you get it in its upright and locked position. Otherwise, you’ll look like an amateur. According to one survey, about 80% of men were growers, while the remaining 20% were showers, by the way.
How to Measure a Cock
You will notice a tendency for men to overestimate and often intentionally overstate the size of their cocks. In reality, the exact size doesn’t matter. And as your instructor, I literally have never measured a cock nor have I asked a guy what size he is. I don’t care. You shouldn’t care. You’re going to have to deal with whatever size he has regardless of what that is, so the specific numbers are largely irrelevant. If you get to the point where you start choosing partners based on cock size, you’ve probably become a bit too narrow-minded (unless you’re just looking to get laid by someone with a huge cock, of course). That would be the same as a guy choosing partners based on how deep or how wide your cunt was, and you probably wouldn’t be too fond of that idea.
It is important to know the approximate size, however, in order to buy condoms, especially since each manufacturer has their own designations for specific size ranges. If he’s the one buying condoms, then so long as he knows what he’s doing, that’s fine (though many men do buy ill fitting condoms). If you’re going to be buying condoms for a specific guy for your Slut Kit, you’ll need to know his length and girth (circumference). Therefore, you’ll need to know the correct way to measure the things. The basic steps are as follows:
Get his cock erect – not soft erect but a nice hard erection.
Use a flexible fabric measuring tape and measure from the tip of the head of the penis all the way to the base (where it attaches to the body) along the top of his cock. Be sure and press into the pubic bone because body fat can often hide a bit of the penis. This is the length.
Use the same measuring tape and wrap it around the penis midway between the head and the base. This will be the circumference, or girth. You can divide it by 3.14 to get the penis’ diameter.
Now that you have those two measurements, you can use the charts on condom manufacturer’s websites to determine which condoms they make that would work best for that penis.
Does Size Matter?
This question is as old as the penis itself, I’d suspect.
The key, however, is making sure the guy knows how to use what he’s got. A large penis doesn’t mean better sex just because it’s a large penis. Conversely, sex with someone who has a smaller penis but knows what he’s doing with it can be very rewarding. Just as with the sizes and shapes, a knowledge and understanding of how to use the thing varies from one guy to the next as well. Once you’re experienced with a variety of cocks, you’ll be in a better position to teach him how to do you with what he has. That is an important skill to have as a slut.
You will find that oral sex on a penis with less girth is a bit easier because you’ll be able to get the entire thing in your mouth. The wider cocks will be difficult to get into your mouth much more than three to five inches (depending on the size of your jaw and mouth), and you’ll likely not be able to deepthroat them at all. Specific techniques for managing these are discussed in a later module.
The most important issues you’ll have to deal with in this area are going to revolve around the psychological ramifications of his perception of the size of his cock, especially relative to others. Men are very, very sensitive about how big they are.
Shyness about penis sizes impacts many facets of a man’s life, to include even being naked around other men at the gym or on a clothing optional beach. It is a serious issue and you must treat it as such. Failure to do so could not only damage your relationship with him (if you’re concerned about that), but could damage his psyche for the balance of his active sex life (something you should be concerned about as an ethical slut). Here are some important tips you need to keep in mind with respect to this:
You should never make fun of a guy’s penis size, just as you wouldn’t want a guy making fun of any part of your body. You need to encourage and preach to him that it is far more important that he know how to use what he has than how big it is. I’ve lost count of the number of guys I’ve been with who have larger than average cocks but had little idea of how to use them (that happens with the smaller ones as well, by the way). A lot of men with larger cocks think all they have to do to make sex good for you is to jackhammer you with it – they don’t bother to learn any serious technique. So the sex can often suck and the big cock is for naught. Regardless of the size of his dick, though, he needs to avail himself of instructional material on the use of his tool and develop some self-confidence with it.
Some guys are going to have issues with the fact that, as a slut, you’ve likely fucked other men who’ve had larger penises. They may ask you about it (some will even get off on that). You’ll need to decide how to respond to that sort of interrogation. I suggest you find a way to avoid it or not answer it because it isn’t any of his business and generally has no direct bearing on the sex you’ll be having with him. If he persists, you need to discuss with him the rationale he has for his infatuation with the topic and deal with that aspect of it.
Large penises are often overrated. Once you get above 6 to 7 inches, the ability to be taken in totally by the mouth (and sometimes the anus) gets less likely. A large penis doesn’t mean “best” or even “good,” but rather merely reflects a comparison to other men.
Older, more mature men will generally be more comfortable with the size of their cocks, even if they’re smaller than average. Overt infatuation with penis size is a sign of immaturity and inexperience as a general rule.
Ultimately, it’s not your job to get him comfortable or happy with his penis size. You can encourage him and let him know that he satisfies you (assuming he does) and all of that. But he’s going to have to come to the realization that his penis is as large as it’s going to get and, short of surgery, there’s nothing that’s going to change that. He has to learn to use what he has. Period. It may get to the point where you have to tell him that outright. Tell him you’ll work with him to find ways to make that cock work for the both of you. An example of this would be explaining that smaller cocks make anal sex much more easier for you as the receiver.
If you’re with a guy on a one night stand, you’ll need to be prepared to deal with any size cock. Most of the instructional material you’ll find for the different techniques around the Slut Academy will address any necessary differences related to the size of a penis if it is relevant. Knowing how to handle different sizes appropriately is, again, something a slut should master.
If you know a guy has issues with his size and you keep telling him it’s “huge,” he’ll know you’re lying and is going to feel as though you’re patronizing him. Don’t lie to someone about this.
If a man has a penis that is too large for you to deal with orally or anally, then let him know if/when things begin to hurt or get to the point where you can’t or don’t want to deal with it. The two of you should work together to figure out how to work around this problem (many positions work better for guys with larger penises than others, for example). Again, many suggestions are included in the instructional material throughout the Slut Academy.
A man who is compulsively obsessive about his penis size will likely have some other issues he needs to deal with (like a low self esteem or sense of self worth, etc.) and is projecting these insecurities onto his penis. Or perhaps he’s too drawn into porn and its unrealistic portrayal of sexuality. Regardless, this is the kind of thing a professional therapist will need to address. While you should not chide a guy for having a smaller than average penis, it is also not your role to assuage his insecurities about it.
Erection Firmness
Most guys get a rather stiff erection, but there are those whose cocks aren’t stiff as a board, making the cock somewhat flexible. For some guys this is normal (the larger the cock, the increasing relative lack of firmness, generally speaking), but for others it may portend medical conditions. One distinct advantage that a less than board-stiff cock has is that it is much more pliable, making it easier to flex into your throat once you learn how to deep throat a cock. It can also make creative positioning with anal sex a bit more interesting. As I said before, penises are highly individualized. Learn to work with the penis you have at your disposal to make the sex work for both of you.
Pubic Hair
When a boy reaches puberty he begins developing pubic hair. In the male, the hair will cover the base of the shaft, the scrotum, and most of the remainder of the pubic area, to include back along the perineum and the asshole. Some guys will not manage this hair and it will get unruly. You may even end up losing his cock if it gets to be too much of a forest! Fortunately, most men at least trim their pubic hair when it becomes unmanageable. This has the benefit of making things a bit easier to get to as well as making the cock appear larger. Hair can hide a good inch or two of his tool, so if you encounter a guy who’s unkempt down there, remind him of this if that bothers you. Perhaps he’ll get the hint.
The trend these days is very close trimming or complete removal of the pubic hair, especially among younger men. There are probably a variety of reasons for this, including perceived hygiene issues and its prevalence in porn. Many of the men in porn videos these days (including the amateur stuff) have completely bare pubic areas. Additional reasons for this might include:
It makes their cocks look bigger (the last inch or so is not lost in the forest)
It makes for better hygiene (less smell, less sweat, etc.)
It makes it easier to see their cock at work when it’s fucking you
It presents a much cleaner, neater appearance in general
It means less pubic hair getting in the mouth of the person going down on them
It usually results in more ball licking/sucking because the person going down on them won’t be getting hair in his mouth
There’s less mess to deal with after sexual intercourse
And while many men shave the hair off, there are salons and spas that perform waxing on male intimate areas as well. Male Brazilian waxing has become rather popular over the past few years, and involves removal of all the hair below the belt, to include around back, the butt, and in the butt crack (which makes for a much nicer experience with rimming, by the way).
Everyone has their own preferences. Some like the bare look, some don’t. Regardless, as a slut, it is not your role to judge, but rather to deal with what you’re handed. Personally, I prefer licking and sucking on a cock and balls that are hairless just because I don’t care for having hair in my mouth.
In this block, we will consider two regions of the body, the abdomen and pelvis, and the anatomy of the internal organs found there. Although often considered separately, the abdomen and pelvis. They act together to provide multiple vital functions including: support and protection of the digestive and urinary tracts and internal reproductive organs and their associated neurovascular supplies; transmission of the neurovascular supply to and from the thorax and the lower limb; provision of support and attachment to the external genitalia and access to and from the internal reproductive and urinary organs; provision of accessory muscles of physiological actions such as respiration, defecation, and micturition; support for the spinal column in weight bearing and movement.
OSTEOLOGY and MUSCULOSKELETAL BOUNDARIES OF THE LESSER PELVIS
Osteology
Refer to an articulated bony pelvis and a skeleton. The pelvis (L. pelvis, basin) is formed by two hip bones (coxal bones, ossa coxae) joined posteriorly by the sacrum. Each hip bone is formed by three fused bones:pubis, ischium, and the ilium. These three bones are fused at the acetabulum. The coccyx is attached to the sacrum. As you study isolated bones such as the hip bone, compare its features with the articulated bony pelvis and the skeleton. 1. On the hip bone identify the:
Pubic symphysis - midline fusion between the bodies of the right and left pubic bones
Pubic crest - superior margin of the body of the pubic bone directly lateral to the pubic symphysis. The pubic crest lies within the coronal plane.
Pubic tubercle - prominence located at the lateral end of the pubic crest
Superior pubic ramus - stout process extending posterolaterally from the pubic tubercle to the iliopubic eminence (see below). The superior pubic ramus forms the superior boundary of the obturator foramen.
Iliopubic eminence - prominence at a point of fusion between the ilium and the superior pubic ramus; medial to the AIIS is a shallow groove, over which the psoas major and the iliacus muscles pass on their way to the lower extremity; this groove is bounded medially by the iliopubic eminence.
Ischiopubic ramus - formed by the ischial ramus, a process that extends superomedially from the body of the ischium, and the inferior pubic ramus, a process extending inferolaterally from the body of the pubic bone. These two rami meet roughly halfway to form a structure collectively called the ischiopubic ramus. The ischiopubic ramus forms the inferior boundary of the obturator foramen.
Pubic arch - bony arch formed by the right and left ischiopubic rami, right and left bodies of the pubic bones, and the inferior end of the pubic symphysis. Note that the subpubic angle (angle of the pubic arch) is wider in females than in males.
Ischial tuberosity - prominence at the lateral end of the ischiopubic ramus. The ischial tuberosity is the bony structure that bears one’s weight when one sits.
Ischial spine - pointed process extending posteriorly from the body of the ischium.
2. On the sacrum, identify the:
Sacral promontory - most anteriorly projecting part of the S1 vertebra.
Anterior sacral foramina - openings permitting the exit of the ventral rami of sacral spinal nerves.
3. Identify the coccyx at the caudal end of the sacrum. 4. Examine the ischium. Note that the ischial spine divides the posterior margin of the body of the ischium into two large notches - the greater sciatic notch (located superior to the ischial spine) and the lesser sciatic notch (inferior to the ischial spine). 5. Using an atlas illustration, study the joint between the sacrum and ilium. The sacroiliac articulation is a synovial joint between the auricular surfaces of the sacrum and the ilium. The sacroiliac articulation is strengthened by an anterior sacroiliac ligament and a posterior sacroiliac ligament. The articulation between the ilium and the L5 vertebra is strengthened by the iliolumbar ligament. Do not attempt to find these ligaments on the skeleton or cadaver. 6. The hip bone and sacrum are connected by strong ligaments. On a model with pelvic ligaments, identify thes acrotuberous ligament, a ligament extending from the inferolateral angle of the sacrum (“sacro-”) to the ischial tuberosity (“-tuberous”). 7. Identify the sacrospinous ligament, a ligament extending from the inferolateral angle of the sacrum (“sacro-”) to the ischial spine (“-spinous”). 8. Note that the sacrotuberous and sacrospinous ligaments convert the greater and lesser sciatic notches into greater and lesser sciatic foramina, respectively. The greater sciatic foramen is located superior to the sacrospinous ligament. The lesser sciatic foramen is located inferior to the sacrospinous ligament, between it and the sacrotuberous ligament. 9. Identify the pelvic inlet (superior pelvic aperture), a large communication between the greater pelvis (also called the false pelvis or pelvis major) and the lesser pelvis (also called the true pelvis, pelvis minor, or the “obstetric pelvis”). The greater pelvis is situated superior to the pelvic inlet and is bounded bilaterally by the right and left alae of the ilium, the wing-like upward projections of the right and left ilia. The concave anterior surface of the ala of each ilium is called the iliac fossa. The cavity of the greater pelvis is considered to be part of the abdominal cavity.
10. The bony ridge forming the border around the pelvic inlet is called thepelvic brim (lower right panel). From anterior to posterior, identify the structures that form the pelvic brim:
Superior end of the pubic symphysis
Posterior border of the pubic crest
Pecten pubis (pectineal line) - a sharp line passing along the back edge of the superior pubic ramus. NOTE: The pectineal ligament (of Cooper) is an extension of the lacunar ligament (the lacunar ligament is part of the aponeurosis of the external oblique muscle that is reflected backward and laterally to attach to the pectineal line; recall that it is also rigid medial boundary of the femoral ring) along the pectineal line of the superior pubic ramus. Cooper’s ligament is used in surgical procedures to support pelvic visceral structures that have prolapsed (e.g. the most successful type of pelvic organ prolapse surgery is retropubic suspension. This procedure involves the attachment of the prolapsed structure to Cooper’s ligament). You will hear a lot about this in the OB/GYN clerkship.
Arcuate line of the ilium - continuation of the pectineal line between the ilium and the ischium toward the sacrum.
Anterior border of the ala (wing) of the sacrum
Sacral promontory
11. The lesser pelvis is located inferior to the pelvic inlet and extends inferiorly to the urogenital and pelvic diaphragms, which close the pelvic outlet (described later).
Musculoskeletal Boundaries of the Lesser Pelvis
INGUINAL CANAL AND SPERMATIC CORD
Inguinal Canal Each of the three flat muscles contributes to the formation of the rectus sheath and the inguinal canal. The external abdominal oblique muscle forms the most superficial portion of the inguinal canal, the internal abdominal oblique muscle forms the intermediate layer of the inguinal canal and the transversus abdominis muscle contributes to the deepest layer of the inguinal canal. Dissection Overview: Scrotum, Testis, and Spermatic Cord
The scrotum is an outpouching of the anterior abdominal wall, and most layers of the abdominal wall are represented in its structure. The superficial fascia of the scrotum contains no fat. Instead, the superficial fascia is represented by dartos fascia (continuous with Colles fascia of the perineum and Scarpa’s fascia, the membranous layer of the superficial fascia of the anterior abdominal wall), which contains smooth muscle fibers (dartos muscle). The scrotum should be opened by a vertical incision along its anterior surface. Observe that the scrotal septum divides the scrotum into left and right compartments. The spermatic cord will be followed from the superficial inguinal ring into the scrotum.
Dissection Instructions: Spermatic Cord
The spermatic cord contains the ductus deferens, testicular vessels, lymphatics, and nerves. The contents of the spermatic cord are surrounded by three fascial layers, the coverings of the spermatic cord, which are derived from layers of the anterior abdominal wall. These coverings are added to the spermatic cord as it passes through the inguinal canal. Dissection Instructions: Testis The testis is covered by the tunica vaginalis, a serous sac that is derived from the parietal peritoneum (it is a remnant of the processus vaginalis). The cavity of the tunica vaginalis is only a potential space that contains a very small amount of serous fluid. The tunica vaginalis has a visceral layer (lining the testis) and a parietal layer (lining the walls of the cavity of the tunica vaginalis). Note that the spermatic fasciae also cover the testis, superficial to the parietal layer of the tunica vaginalis. The spermatic fasciae are very thin here and difficult to separate from the parietal layer of the tunica vaginalis.
ISCHIOANAL FOSSA
Dissection Overview: Gluteal Region
You studied the gluteal region as part of the Musculoskeletal-Integumentary Block. You will return to the gluteal region to trace the pudendal nerve and the internal pudendal artery where they pass through the greater sciatic foramen inferior to the piriformis muscle, and then pass through the lesser sciatic foramen between the sacrotuberous and sacrospinous ligaments. From there they pass into the anal triangle. Dissection Overview: Anal Triangle and Ischioanal Fossa
The perineum is a diamond-shaped area between the upper thighs and between the lower parts of the buttocks. It consists of structures that constitute the region below the pelvic floor. The perineum is bounded by the pubic symphysis anteriorly, the coccyx posteriorly, and the two ischial tuberosities laterally. Between the pubic symphysis and ischial tuberosities are the rami of the pubic bone and the rami of the ischia (since it is difficult to demarcate where the inferior ramus of the pubic bone ends and the ischial ramus begins, it is common parlance to call these structures “ischiopubic rami”). Extending from the ischial tuberosities to the coccyx (and sacrum) are the sacrotuberous ligaments. For descriptive purposes, it is convenient to divide the diamond-shaped perineum into two triangles. The anal triangle is the posterior part of the perineum and it contains the anal canal and anus. The urogenital triangle is the anterior part of the perineum and contains the urethra and the external genitalia. At the outset of dissection, it is important to understand that the pelvic diaphragmseparates the pelvic cavity from the perineum
The order of dissection will be as follows: Dissection of the anal triangle will begin with removal of skin covering the ischioanal fossa. The nerves and vessels of the ischioanal fossa will be dissected. The fat will be removed from the ischioanal fossa to reveal the inferior surface of the pelvic diaphragm. Dissection Instructions: Anal Triangle and Ischioanal Fossa
The ischioanal (ischiorectal) fossa is a wedge-shaped area on either side of the anus. The apex of the wedge is directed superiorly and the base is beneath the skin. The ischioanal fossa is filled with fat that helps accommodate the fetus during childbirth or the distended anal canal during the passage of feces. The ischioanal fat is part of the superficial fascia of this region. The goal of this dissection is to remove the fat and identify the nerves and vessels that pass through the ischioanal fossa. The pudendal nerve gives rise to the inferior rectal, perineal and dorsal nerves of the penis. You dissected the inferior rectal nerve and should appreciate that it supplies the external anal sphincter, the lining of the lower part of the anal canal, and the circumanal skin. The perineal nerve gives rise to posterior scrotal or labial and muscular branches to the superficial and deep transverse perinei, bulbospongiosus, ischiocavernosus, and sphincter urethrae muscles. The dorsal nerve of the penis supplies the corpus spongiosum. In males it runs on the dorsum of the penis to end in the glans penis. In females the dorsal nerve of the clitoris is very small.
SUPERFICIAL PERINEAL POUCH
Overview
The perineum is a diamond-shaped area between the upper thighs and between the lower parts of the buttocks. It consists of structures that constitute the region below the pelvic floor. The perineum is bounded by the pubic symphysis anteriorly, the coccyx posteriorly, and the two ischial tuberosities laterally. Between the pubic symphysis and ischial tuberosities are the rami of the pubic bone and the rami of the ischia (since it is difficult to demarcate where the inferior ramus of the pubic bone ends and the ischial ramus begins, it is common parlance to call these structures “ischiopubic rami”). Extending from the ischial tuberosities to the coccyx (and sacrum) are the sacrotuberous ligaments. For descriptive purposes, the diamond-shaped perineum is divided into two triangles. The anal triangle is the posterior part of the perineum and it contains the anal canal and anus and has already been dissected. The urogenital triangle is the anterior part of the perineum and contains the urethra and the external genitalia. At the outset of dissection, it is important to understand that the pelvic diaphragm separates the pelvic cavity from the perineum.
Surface Anatomy of the Male Genitalia
Recall that the Pelvis and Perineum chapter of ORSA was skipped in the fall. You are now responsible for that. For your convenience a bolded term list is shown below. You should utilize the ORSA manual AND an anatomy text (such as Moore) to learn these structures. They will be included on the P+P practical.
Because of the variability of the genitalia of the cadavers, and the fact that as the dissection of this area progresses the surface anatomy of the genitalia will be compromised, a male and female cadaver will be placed in the dissection laboratory specifically for surface anatomy study.
Penis
Prepuce (foreskin) - note: if your cadaver has a circumcised penis, it will not have a prepuce. Find a cadaver that does. We will write the numbers of the lucky tables on the blackboards.
Overview: Deep Perineal Pouch / Urogenital (UG) Diaphragm
The deep perineal pouch (space) will not be dissected. The deep perineal pouch / urogenital diaphragm is a fibromuscular structure sandwiched between two fascial layers: the inferior fascia of the UG diaphragm (perineal membrane) and a similar layer, the superior fascia of the UG diaphragm. These facial sheets stretch horizontally across the pubic arch and attach to the anterior portion of the ischiopubic rami. The contents of the deep perineal pouch in the male include the membranous urethra, external urethral sphincter muscle, bulbourethral glands, the dorsal artery of the penis (a branch of the internal pudendal artery), and the dorsal nerve of the penis (a branch of the pudendal nerve).
The pubococcygeus muscle or PC muscle is a hammock-like muscle, found in both sexes, that stretches from the pubic bone to the coccyx (tail bone) forming the floor of the pelvic cavity and supporting the pelvic organs. It is part of the levator ani group of muscles.
Structure
The pubococcygeus arises from the back of the pubis and from the anterior part of the obturator fascia, and is directed backward almost horizontally along the side of the anal canal toward the coccyx and sacrum, to which it finds attachment.
Between the termination of the vertebral column and the anus, the two pubococcygei muscles come together and form a thick, fibromuscular layer lying on the raphé (anococcygeal raphé) formed by the iliococcygei.
The greater part of this muscle is inserted into the coccyx and into the last one or two pieces of the sacrum.
Variation
This insertion into the vertebral column is, however, not accepted by all observers.
Function
The Pubococcygeus muscle controls urine flow and contracts during orgasm. It also aids in childbirth as well as core stability.
A strong pubococcygeus muscle has also been linked to a reduction in urinary incontinence and proper positioning of the baby’s head during childbirth.
Kegel exercises
The Kegel exercises are a series of voluntary contractions of all the perineal muscles. Such movement is done in an effort to strengthen all the striated muscles in the perineum’s area. They are often referred to simply as “kegels”, named after their founder, Dr. Arnold Kegel.
These exercises also serve to contract, among others, the ischiocavernosus, bulbocavernosus, and cremaster muscle in men, as voluntary contraction of the pubococcygeus muscle also engages the cremasteric reflex, which lifts the testicles up, although this does not occur in all men. Kegel exercises have been prescribed to ameliorate erectile dysfunction due to venous leakage and to help men control premature ejaculation and to treat urinary incontinence in both sexes.
Well, assuming that your anatomy is more-or-less average, you’ll know what a penis looks like - at least, you know what a circumcised or an uncircumcised penis looks like, depending on what happened to you soon after you were born. But the penis is a very variable organ, perhaps even the one that varies more than any other in the human body, and so unless you have had some experience of sex with men, you may not have seen the huge variety of size and shape between men.
Having said that, if you can get an erection, masturbate and ejaculate, enjoy sex and urinate normally, and you have no infections, phimosis or other problems, then you really don’t have anything to worry about.
Basic anatomy of the uncircumcised penis
Your penis is basically a very specialized roll of flesh with a hollow tube down the middle. This tube, the urethra, is the passage to the outside world for urine and semen. It normally opens as either a small round hole or a long narrow slit on the tip of the glans, although some men have a condition called hypospadias, where the urethra opens somewhere on the underneath of the penile shaft. Often there are two little lips surrounding the end of the urethra on the glans. These lips are full of nerve endings which can provide immense excitement during sexual play.
The glans is the most sensitive part of the penis, as you’d expect, since it leads the way into the vagina during sexual intercourse. Both the coronal ridge of the glans and the frenulum seem to be important in stimulating ejaculation during intercourse.
The frenulum is one of the most sensitive spots on the entire penis, but it is often cut away during circumcision. And Hugh Young, of Intactivism, points out that the foreskin, also removed during circumcision, may actually be more pleasure-sensitive than the glans. If you want to see some of the unfortunate (and not uncommon) harmful consequences of circumcision, check out the photos here.
Inside the penile shaft, the urethra is surrounded by spongy tissue called the corpus spongiosum. During sexual arousal, a network of small arteries fills the corpus spongiosum with blood. This blood cannot escape because the veins near the base of the penis are constricted by the swelling of the spongy tissue of the corpus spongiosum. In the diagram above you can see that there are two other channels of spongy tissue in the penile shaft, each known as a corpus cavernosum, and these also fill with blood during an erection. As the amount and pressure of blood in the penis increases, an erection begins to develop. If sexual arousal continues, the continuing constriction of the veins traps more blood inside the penis and the erection proceeds to full firmness.
If the penile arteries become blocked by fatty deposits or the veins leak, a man is likely to develop impotence or erectile dysfunction - which means he cannot get an erection or maintain one.
Unfortunately, as a man ages, the blood supply to his penis can decrease because of the increased amounts of fat which are deposited in his penile arteries - and it doesn’t take much to block them, for they are very small in diameter. Such reduced blood flow slowly causes the muscle fibers inside the penis, whose job is to regulate blood flowing through the blood vessels, to degenerate into connective tissue. The greater the amount of connective tissue, the greater the difficulty getting an erection - eventually it will be impossible to get an erection at all. There can also be an apparent reduction in penis size as a man gets older - partly due to this change in tissue structure, and partly due to the amount of fat around his abdomen increasing, so that the base of his penis shaft is less obvious and its apparent size becomes shorter.
Even in a penis with clear arteries, it seems that normal blood flow may not be sufficient to keep the internal tissues healthy, and some doctors have suggested that the function of spontaneous erections during sleep is to ensure good oxygenation of the penis through increased blood flow. In short, it seems that the more erections you have, the healthier your penis will be! It certainly seems logical to me that regular erections are both natural and necessary for ensuring optimum health and maximum size.
The penis goes deep back inside the body, with its “root” reaching back underneath the prostate gland towards the anus. This hidden penile tissue is very sensitive, and stimulating it during sex with fingertip pressure applied either through the scrotum or on the perineum (the area between scrotum and anus) can be very pleasurable.
A lot of men have a penis which shows little or no shaft outside their body when they are not sexually aroused, and it is this hidden part of the penis which can generate a sizeable erection when they become sexually aroused. This is described in greater detail on the size page of this website.
You may have noticed a line along the underside of your penis. This is the “raphe”. As you developed in your mother’s uterus, your penis formed as a tube of flesh which gradually sealed along its length. Normally, the only sign of this process after birth is this thin ridge of skin along the underside of the penis.
The skin of the penis contains muscle fibers which extend from the muscles of the scrotum. These muscle fibres control whether you have a scrotum which hangs loosely, or one which is held tighter against your body. The more active the muscle, the tighter and more crinkly your scrotum appears. Of course, cold water and fear can also cause the muscles to contract, and, as you know, your penis and scrotum will then shrink and appear much smaller.
The length of the foreskin is highly variable, so that in some men there is only partial coverage of the glans, even when the penis is flaccid.
As we said before, the frenulum is one of the most sensitive parts of the penis, but it is often removed during circumcision, along with the foreskin. There’s a picture below of what the frenulum looks like on an uncircumcised man with his foreskin retracted. The foreskin is tethered to the shaft of the penis by the frenulum, which stops it retracting too far and causes it to move forward again after it has been pulled backwards.
The outer surface of the foreskin is skin, but the inner surface is a sensitive mucous membrane that contains sebaceous glands which lubricate and protect the glans from friction. Because circumcision removes these lubricating glands, many circumcised men complain that their glans tissue is too sensitive as it rubs against their clothing. Generally, the foreskin is much larger than you might think - it can be up to ninety square centimeters in area in an adult man. Considering how many more nerve cells the foreskin has compared to the glans, one might guess that circumcision destroys a great deal of a man’s sexual sensitivity.
Finally, the ridged bands on the inner surface of the foreskin near the tip merge with the frenulum and have the highest number of nerve endings of any part of the foreskin. These nerve endings are of a type sensitive to changes in pressure and tension, and are thought to play a part in stimulating and controlling orgasm and ejaculation during intercourse.
One interesting question is whether or not hypospadias can have an impact on sexual functioning. This is a condition where the foreskin may be incompletely formed, leaving a hooded appearance with an incomplete circumference of the foreskin around the glans. The frenulum is usually missing - which may or may not affect a man’s sexual pleasure - but the question for most men is really one of appearance and sexual functioning. I have only come across one man with hypospadias who reported that he had delayed ejaculation. After using a treatment for retarded ejaculation he reported that his sexual function was normal - he ejaculated within five minutes - after previously not being able to ejaculate at all. I assume this was caused buy the psychological impact of the hypospadias and increased confidence resulting from treatment.
A normal erection is the result of a rather complex process. The penis has three separate tubes that become engorged with arterial blood during arousal. Erotic fantasies or sensory inputs such as the touch, scent, sound or sight of a partner are channeled into the control center in the brain. The aroused brain sends signals down the spinal column to the penile nerves (which may also be stimulated directly by manual stimulation - masturbation, fellatio, or intercourse). The nerve impulses trigger an event involving muscle tissue and blood vessels in the two large erectile cylinders, the corpora cavernosa (singular: corpus cavernosa).
There are arteries and spaces called sinusoids within these cylinders, and smooth muscle tissue surrounds the arteries and spaces. Normally, the smooth muscle tissue keeps both arteries and spaces constricted, but the nerve impulses send a primary messenger called nitric oxide (NO). This molecule tells the smooth muscle tissue to relax, which allows more arterial blood to flow into the penis and the capacity of the penis to dramatically increase in volume. Meanwhile, veins that normally drain blood from the penis are flattened by the expanding volume of blood into the erection chambers. The arterial blood is thus trapped, making the penis very hard and very erect. Continued stimulation keeps the process going and maintains the erection.
Now, here is a more complex description:
Anatomy of the Penis
The penis is composed of three erectile cylinders. A pair of spongy cylinders (the corpora cavernosa) are located side-by-side on top. They join in the midline for about 70 pecent of their length - that part of the penis that extends from the body - and continue separately behind the pubic bone where they are anchored to the underside of the pelvic bony structure, the ischiopubic ramus. Thus, about 30 percent of the penis is buried in the pelvis behind the pubic bone. This bony anchor is very important for normal penile function. Where the corpora cavernosa merge at about the level of the pubic bone, the midline surface between the two cylinders forms an incomplete septum. This is important in that it allows blood to pass freely from one corporal body to another.
A single corpus spongiosum is located below the junction of the two corpora cavernosa. This simple tube encloses the urethra and at its tip forms the glans penis, commonly referred to as the “head” of the penis. The urethra extends from the bladder to the tip of the glans penis.
The spongy erectile tissue within the three cylinders consists of a mass of smooth muscle, often referred to as trabecular smooth muscle, within which is embedded a network of endothelial lined vascular spaces called sinusoids or lacunar spaces.
Surrounding each of the corpora cavernosa is the tunica albuginea, a dense, multi-layered, collagenous sheath that gives the penis flexibility, rigidity and tissue strength. During an erection, one layer of the tunica albuginea stretches lengthways, which allows the penis to become longer, and the other layer stretches crossways, which allows the penis to become thicker. The third cylinder, the corpus spongiosum, is outside the tunica albuginea and does not become rigid. In addition, all three cylinders are covered by a second, less-dense sheath called Buck’s fascia.
Penile Blood Supply
Blood supply to the penis originates from the right and left internal arteries. These arteries are branches of the major blood supply to the pelvis and in turn branch into the deep penile artery that supplies the corpora cavernosa through small vessels known as Helisine arteries or arterioles. In the flaccid state, the small arterioles are contracted and restrict the arterial inflow into the lacunar spaces. In the erect state, relaxation of the small Helisine arteries allows a rapid increase in blood inflow and exposure of the lacunar spaces (sinusoids) to systemic blood pressure. Another branch of the penile artery, the dorsal artery, supplies the glans and the penile skin. The third branch, the bulbourethral artery, supplies the corpus spongiosum.
The most important feature of the venous drainage system is that the tunica albuginea a network of veins, the sinusoidal venules from the lacunar spaces, drains the erectile cylinders when the penis is flaccid. These subtunical venules merge to form emissary venules that exit through the tunica albuginea and pass into the larger venous system, both deep and near the surface. During erection, this network is compressed and stretched by trabecular smooth muscle relaxation. The flow of blood in is strong, the flow out of blood is weak, and the result is an erection.
Neurophysiology of Penile Erection
An erection (tumescence) is a neurovascular event, meaning that both the nervous and the circulatory systems are involved. Recent research has identified specific spots in the brain as the integration centers for sexual drive and sexual arousal, perhaps triggered by psychological factors such as erotic fantasies or expectations. Sensory factors such as audiovisual stimulation also have input through these same brain centers. The brain then controls the penis through two kinds of nerves, autonomic and somatic.
Autonomic nerves are not controlled by the individual and are “automatic” in their timing and function. There are two types: parasympathetic and sympathetic. The parasympathetic nerve fibers originate from the sacral spinal cord, at levels 2, 3 and 4 (S2-4). The sacral parasympathetic input initiates erections. The sympathetic nerves meanwhile originate from the eleventh and twelfth thoracic levels of the spinal segments, as well as the first and second lumbar spinal segments. This thoracolumbar sympathetic pathway controls detumescence and orgasm. In other words, parasympathetic autonomic nerves get it up; sympathetic autonomic nerves let it down and keep it down. As we shall see, complex chemical interactions are involved in this process, which is where Viagra comes into play.
Somatic nerves control sensory and motor functions of the body. Sensory receptors on the glans penis and the penile skin lead to sensory nerves that converge to form the primary dorsal nerve of the penis; this becomes the pudendal nerve which courses up to the sacral segments S2, 3,4.
As noted above, during an erection the penis is transformed from a venous to an arterial organ. Blood flow into the penis is controlled by three neurotransmitter systems: adrenergic nerve fibers; cholinergic nerve fibers; and nonadrenergic-noncholoinergic (NANC) fibers that release nitric oxide (NO). The exact nerve-chemical processes are very complex.
Expressed in its simplest terms, in the body, certain smooth muscle cells (those muscles we cannot control, as opposed to skeletal muscles) respond to chemical signals released by different nerves. In the penis, these chemicals normally keep the penile erectile tissue in the flaccid condition by keeping the smooth muscle cells contracted. But when the conscious or unconscious brain begins to be sexually stimulated, other chemicals are manufactured, which react with the penile erectile tissue (primarily smooth muscle cells) to set up the sequence of events that leads to an erection.
Thus, a series of coordinated vascular events, controlled by autonomic nerves, leads to an erection: relaxation of the smooth muscle in the sinusoids in the corpus cavernosum; increased arterial inflow; and occlusion of the venous drainage from within the erectile spaces. In addition to the vascular components of an erection, there are skeletal-muscular components as well, which are controlled by the somatic (sensory and motor) nerves. These skeletal components play a role in the rigid erection phase.
You can see the interplay of all these actions in the following summary of the phases of erection:
FLACCID PHASE: When the penis is resting, the trabecular smooth muscle within the corpus cavernosum is contracted and arterial blood inflow is minimal, while venous outflow is quite rapid. The blood pressure in the intracorporal space is therefore low, about 4-6 mm of Hg.
INITIAL FILLING PHASE: The parasympathetic nerve stimulation now relaxes the smooth muscle of the small arteries and arterioles resulting in a four to tenfold increase of arterial flow into the penis. Simply put, the penis is rapidly filling up with blood. The increased blood volume in the sinusoids initiates the venous occlusion process due to the stretching of the small veins below the tunica albuginea surface. In this initial filling phase there is very little change in pressure within the two corpora cavernosa.
TUMESCENCE PHASE: In this phase the volume of blood progressively increases and the pressure begins to increase inside each corpus cavernosum. The clamping down of the small veins below the tunica albuginea continues as the pressure increases. As the overall pressure builds up inside the erectile cylinders, the arterial inflow begins to diminish.
FULL ERECTION PHASE: In this phase the trabecular smooth muscle is fully relaxed and the corpus cavernosum is full with newly infused arterial blood. The arterial inflow is now minimal. The penis is rigid. The venous occlusion mechanism is in full force with no venous drainage. The pressure inside the corpus cavernosum is equal to the average arterial pressure, about 100 mm of Hg.
RIGID ERECTION PHASE: During this phase the pressure inside the corpora cavernosa may temporarily increase to several hundred mm of Hg due to contraction of the pelvic floor muscle outside the penis (ischiocavernosus muscle). Arterial inflow is still zero. The somatic penile nerves, primarily in the engorged, supersensitive glans penis, contribute to the sacral nerves to stimulate the pudendal motor nerve which is responsible for contraction of both the ischiocavernosus and bulbocavernosus muscles. A rhythmic contraction of the latter muscle is necessary for ejaculation.
DETUMESCENCE PHASE: Sympathetic (adrenergic) stimulation causes contraction of the trabecular smooth muscle. Very rapidly the venous outflow is re-established. The penis then returns to the flaccid phase.
Keep in mind that the major elements of the erection process are occurring in the two erectile cylinders, the corpora cavernosa. During erection, blood flow certainly also increases to the corpus spongiosum tissue around the urethra and to the glans penis. However, the absence of any tunica albuginea in the covering of the glans penis and the presence of only a very thin tunica covering over the corpus spongiosum means there is no significant venous occlusion. Without the thick tunica covering against which the blood veins of the corpora cavernosa are flattened, there is little increased pressure in the glans and in the third penile cylinder. But, during the rigid erection phase, contraction of the ischiocavernosus muscle and bulbocavernosus muscle do compress the spongiosum and penile veins and result in a measurable change in warmth and tone in the head of the penis.
Nerve/Chemical Interaction With Erectile Tissue
Adrenergic nerves constrict penile blood vessel and corpora cavernosum smooth muscle via alpha-1 adrenoreceptors. Norepinephrine is the neurotransmitter. Blood vessel and smooth muscle relaxation are controlled by cholinergic (with acetylcholine as a neurotransmitter from parasympathetic nerves) and nonadrenergic-noncholinergic (NANC) fibers. Some of the NANC fibers may contain vasoactive intestinal polypeptide. Vasodilation of the penile vascular structures, from primarily cavernous smooth muscle relaxation, following activation of cholinergic and NANC fibers is mediated by nitric oxide and its second messenger cyclic guanosin monophosphate (CGMP).
Second-messenger molecules like cGMP function at the molecular level inside the cell in which they reside, in this case the smooth muscle of the corpora cavernosum. We now see that the NANC neurotransmitter nitric oxide (NO) is critical in producing smooth muscle relaxation and penile erection. NO production (synthesis) results from activation of neurogenic and to a small degree, endothelial NO synthase. Once NO diffuses into the smooth muscle cell, it binds to an enzyme guanylyl cyclase. This causes an increase in guanylyl cyclase activity, resulting in cyclic GMP (cGMP) production or synthesis. This intracellular second messenger then carries out the final step in relaxing smooth muscle, reducing the level of intracellular calcium by binding to cGMP-dependent protein kinases, cGMP-dependent ion channels, and cGMP-regulated phosphodiesterases. The overall amount of intracellular cGMP, is controlled by and regulated by the activity of the phosphodiesterase 5, which helps convert cGMP back to GMR Several other forms of phophodiesterase (PDE) have been identified in penile tissue (types 2, 3, 4 and 5); however, PDE 5 is the predominant phosphodiesterase in human corpus cavernosum and human corpus cavernosa smooth muscle. It also is apparently located just in human penile tissue. Viagra functions to block PDE 5. This allows cGMP levels to remain high and continue their function as a smooth muscle relaxant that potentiates and maintains the penile erection.
