The Precise Mechanism of the PE Response through Manual and Mechanical Intervention.
by Richard R. Howard II, Dr.PH, MS, MPH
The penis is a specialized vascular framework constructed to inflate to a rigid state called erection. The shaft consists of three chambers, the two corpora cavernosa CC on the dorsal side and one corpus spongeosum CS whic lies between CC on the ventral side. Within these chambers are prominent slit like spaces rich in blood cells, as they are really modified veins also called vascular plexus. The slit like vascular spaces are composed of abundant amount of smooth muscle with lesser amounts of fibrous tissue, lined by endothelium, this is called erectile tissue. Separating the CC and CS is a very thick band of connective tissue called the tunica albuginea composed mostly of bi-layered collagen and elastic fibers. The elastic fibers form an irregularly latticed network on which collagen fibers rest. It is this elastic network that gives the penis elasticity, allowing it to expand and contract.
The limiting factor in PE is the tunica albuginea and septum composed of collagen and elastic tissue. The collagen is very tough connective tissue constructed by nature to insure optimum structural integrity or strength. Think of a tendon or ligament, this is also composed of collagen. Your body’s entire structural framework is composed mostly of collagen, including bone.
To cause the penis to grow, you must overcome the structural bonds of the collagen. Through sufficient traction called critical traction when applied consistently along the length and diameter of the penis, the molecular bonds of the collagen will separate and undergo remodeling to a larger size.
The interior tissue is composed mainly of the vascular plexus consisting of epithelium lining, with abundant smooth muscles and some fibrous tissue. When sufficient traction is applied to the collagen, this results in a controlled bond breaking/separation and remodeling process making the collagen longer and larger. Think of separating a brick wall and filling it in with additional bricks resulting in a larger brick wall. The interior vascular plexus goes along for the ride, but itself is transformed into greater mass. The endothelium lining of the vascular slits undergoes mitosis, the abundant smooth muscle framework adjacent to the endothelium undergoes hypertrophy and mitosis (there are studies that support the proposition that mitosis can occur in smooth muscle cells), and the arteries and veins follow the same growth course mentioned above, with the remaining fibrous tissue undergoing remodeling. The slow growing peripheral nerves will grow and elongate when stimulated. Therefore the entire package gets bigger under sufficient constructive critical traction, with the collagenous structure being the limiting factor. If the collagen bond breaking is sufficient, with cementing, the process is likely permanent.
A brief look at “nubie gains”. A “nubie” is a person never implementing PE. Once implemented he will experience characteristic easy gains. Unchallenged or unstressed collagen has slack or crimps allowing a stretching out scenario removing these crimps resulting in quick gains for the beginner. Under this condition, the collagen bonds generally remain intact until the critical traction level is applied.
The attachment points are composed of collagenous tissue called ligaments and skeletal muscular tissue. The main ligaments are called suspensory ligaments and fundiform ligaments. The primary base muscles are called the bulbocavernosus and ischiocavernosus muscles.
Ligaments are composed of densely packed collagen fibers which are white and relatively inelastic. Mechanical properties vary with shape and structural organization. This connective tissues is characterized by sparse cellularity distributed within an extracellular matrix. Cells in tendons and ligaments are called fibroblasts. These ligaments consist of 70-80% collagen and 20% fibroblasts. Upon initiating traction the crimps of the ligament collagen are pulled out or straightened first, then additional traction triggers molecular transformation via molecular bond breaking and remodeling, again resulting in longer, larger ligaments.
The skeletal muscles called bulbocavernosus and ischiocavernosus muscles are attachment points at the base of the penis, therefore traction will elicit the same changes in them as arm curls will elicit in your biceps and triceps. Whilst under traction, all muscular tissue at the base of the penis will undergo hypertrophy, strengthen and thus enlarge.
1. Frank H. Netter, M.D., The Netter Collection of Medical Illustrations, Reproductive System, 1997; Volume 2, Page 9.
2. Gerald Brock, Geng-Long Hsu, Lora Nunes, Burkhard von Heyden, Tom F. Lue -“The Anatomy of the Tunica Albuginea in the Normal Penis and Peyronie’s Disease” – J Urol. 1997; Volume 157, Issue 1, 276-281
3. Robert F. Diegelmann, PhD, Collagen Metabolism, Medical College of Virginia, Virginia Commonwealth University, Richmond, VirginiaPosted: 02/04/2002; Wounds. 2001;13(5) © 2001 Health Management Publications, Inc.
4. Tetsuya Nakatani Takashi Marui Toshiaki Hitora Minoru Doita Kotaro Nishida Masahiro Kurosaka. Mechanical stretching force promotes collagen synthesis by cultured cells from human ligamentum flavum via transforming growth factor‐β. J Orthopaedic Res. November 2002; Volume 20, Issue 6, Pages: 1380–1386.
5. 5. 5 Hsu G-L , Brock GB , Martinez-Pineiro L , Nunes L , von Heyden B , Lue TF . The three-dimensional structure of the tunica albuginea: anatomical and ultrastructural levels. . Int. J. Impotence Res. . 1992;4:117 .
6. Balestrini JL, Billiar KL. Magnitude and duration of stretch modulate fibroblast remodeling. J Biomech Eng. 2009 May;131(5):051005. I
7. Baek SR et al, J Elast 80:13–31, 2005.
8. Driessen NJB et al, Biomechan Model Mechanobiol.7:93–103, .2008.
9. Humphrey JD et al, Math Models Methods Appl Sci 12:407–430, 2002