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.

Male infertility (MI) and male sexual dysfunction (MSD) can often coexist together due to various interplay factors such as psychosexual, sociocultural and relationship dynamics. The presence of each form of MSD can adversely impact male reproduction and treatment strategies will need to be individualized based on patients’ factors, local expertise, and geographical socioeconomic status. The Asia Pacific Society of Sexual Medicine (APSSM) and the Asian Society of Men’s Health and Aging (ASMHA) aim to provide a consensus statement and practical set of clinical recommendations based on current evidence to guide clinicians in the management of MI and MSD within the Asia-Pacific (AP) region. A comprehensive, narrative review of the literature was performed to identify the various forms of MSD and their association with MI. MEDLINE and EMBASE databases were searched for the following English language articles under the following terms: “low libido”, “erectile dysfunction”, “ejaculatory dysfunction”, “premature ejaculation”, “retrograde ejaculation”, “delayed ejaculation”, “anejaculation”, and “orgasmic dysfunction” between January 2001 to June 2022 with emphasis on published guidelines endorsed by various organizations. This APSSM consensus committee panel evaluated and provided evidence-based recommendations on MI and clinically relevant MSD areas using a modified Delphi method by the panel and specific emphasis on locoregional socioeconomic-cultural issues relevant to the AP region. While variations exist in treatment strategies for managing MI and MSD due to geographical expertise, locoregional resources, and sociocultural factors, the panel agreed that comprehensive fertility evaluation with a multidisciplinary management approach to each MSD domain is recommended. It is important to address individual MI issues with an emphasis on improving spermatogenesis and facilitating reproductive avenues while at the same time, managing various MSD conditions with evidence-based treatments. All therapeutic options should be discussed and implemented based on the patient’s individual needs, beliefs and preferences while incorporating locoregional expertise and available resources.