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Address correspondence to Anthony J. Viera, LT, MC, USNR, Family Practice Department, PSC 490, Box 9097, U.S. Naval Hospital, Guam, FPO AP 96538-1600. Reprints are not available from the authors.
Detumescence is influenced by alpha-adrenergic tone. Alpha-1 receptors predominate in the trabecular smooth muscle cells of the corpora cavernosa, alpha-2 receptors are the predominant receptors in the cavernosal arteries, and both alpha-1 and alpha-2 receptors are present in the circumflex and deep cavernosal veins.
The pressure from the expanding penis compresses the veins (blood vessels that drain the blood out of the penis) in the tunica albuginea, helping to trap the blood in the corpora cavernosa, thereby sustaining erection. Erection is reversed when cGMP levels in the corpora cavernosa fall, causing the smooth muscles of the corpora cavernosa to contract, stopping the inflow of blood and opening veins that drain blood away from the penis. The levels of the cGMP in the corpora cavernosa fall because it is destroyed by an enzyme called phosphodiesterase type 5 (PDE5)
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