Rigi10™ Malleable Penile Prosthesis
Also Known As
Deep fascia of the penis, Gallaudet's fascia, fascia of the penis
Definition
Buck’s fascia, also known as the deep fascia of the penis or Gallaudet’s fascia, is a strong, deep fascial layer that encases the three erectile bodies of the penis: the two corpora cavernosa and the corpus spongiosum.¹ It is a multi-layered structure, typically described as having an inner circular and an outer longitudinal layer, playing a crucial role in penile anatomy and function.³ Anatomically, it is situated superficial to the tunica albuginea, the fibrous sheath directly covering the erectile tissues, and is considered a continuation of the deep perineal fascia (investing fascia of the perineum).¹ Buck’s fascia acts as a containing layer, compartmentalizing the neurovascular structures of the penis. The deep dorsal vein, dorsal arteries, and dorsal nerves of the penis are located deep to or within specific compartments created by Buck’s fascia.³ Its integrity is vital for normal erectile function, as it helps to limit venous outflow from the corpora cavernosa during erection by compressing the emissary veins against the relatively inelastic tunica albuginea, thus contributing to penile rigidity.² It also provides structural support and defines the contour of the penis.¹
Clinical Context
Buck’s fascia is clinically vital in various urological conditions and procedures.¹ Its anatomical location and structural properties make it a key consideration in penile surgery and the pathophysiology of certain penile disorders.
In surgical procedures such as penile prosthesis implantation, repair of penile fractures, urethroplasty for urethral strictures, and correction of Peyronie’s disease, meticulous handling of Buck’s fascia is crucial.4;6 Preserving Buck’s fascia and neurovascular bundle can help minimize complications like postoperative edema, sensory loss, and erectile dysfunction.6 For instance, during penile implant surgery, incisions are often made through or alongside Buck’s fascia to access the corpora cavernosa, and careful closure is necessary.4
Penile trauma, including penile fracture (rupture of the tunica albuginea of the corpora cavernosa), often involves tearing of the overlying Buck’s fascia. The extent of Buck’s fascia disruption can influence the degree of hematoma and swelling.¹ Surgical repair typically includes the tunica albuginea and Buck’s fascia closure.
Infections like Fournier’s gangrene, a necrotizing fasciitis of the perineum and genital region, can spread along fascial planes. While Buck’s fascia can be a temporary barrier, severe infections can penetrate it, leading to more extensive tissue damage.5
Conditions like Peyronie’s disease, characterized by plaque formation in the tunica albuginea, may also involve inflammatory changes in the adjacent Buck’s fascia. Surgical treatment for Peyronie’s disease often requires dissection around or through Buck’s fascia to access and treat the plaque.6
Understanding the anatomy of Buck’s fascia is also essential for diagnostic imaging of the penis, such as ultrasound or MRI, in evaluating penile pathologies.¹