Morphology and morphometry of the fundiform and suspensory ligaments of the penis in Thai population

The fundiform ligament and penile suspensory ligament (PSL) are essential for maintaining prepubic curvature and stabilizing erections. PSL dissection is a key step in penile lengthening surgery for micropenis; however, the precise origin and insertion of the fundiform ligament, as well as the insertion of the PSL, remain subjects to debate. In this study, 34 embalmed male cadavers without pathology or prior pelvic or perineal surgery were dissected layer by layer from the lower abdominal wall to the penile base. The fundiform and PSL were identified, and their origin, insertion, morphology, length, and vascular associations were documented. Four distinct shapes of the fundiform ligament were identified: double, triangular, Y-shaped, and irregular type, with the double type being most common. The majority originated from the linea alba, while some arose from Scarpa's fascia or both, inserting distally into the superficial penile fascia. The external pudendal artery was observed near its insertion in 56% of cases. The PSL consistently exhibited a triangular configuration, with an average depth of 27.4±5.7 mm along the pubic symphysis. The angle between the pubic margin and penile shaft margin measured 58.6°±9.7°. The deep dorsal vein of the penis was identified at the deep margin of the PSL in 53% of specimens. These findings provide detailed anatomical insights into the penile suspensory apparatus, highlighting structural variations, origins, and relationships with adjacent vascular structures. Further surgical validation is required to establish their clinical implications in penile lengthening procedures.