In regards to smooth muscle , I think it is somewhat mis-understood that we cannot control the smooth muscle in the corpora cavernosa’s (CC’s) compared to other smooth muscles found in the body. Smooth muscles cells in the CC can be controlled (I.e. Relaxed) by increasing blood volume within the blood vessels of the penis through jelqing. Normally SMC’s are contracted in the CC, causing reduced blood vessel diameter and the penis to be flaccid. However, to get an erection, the nervous system stimulates nitric oxide (NO) production which relaxes the smooth muscle cells, causing increased blood vessel diameter. The increased blood vessel diameter causes stress on the cells lining the blood vessels (endothelial cells) . This stress causes the endothelial cells to produce more NO , thereby further relaxing the smooth muscle cells and allowing for maximum blood flow into the penis.
See: http://www.ncbi .nlm.nih.gov/pm … les/PMC1351051/ (figure 3: note the cavernosa nerve cell and endothelial cell and NO production).
Also see: (note the last sentence of the abstract section: "Thus, nNOS may initiate cavernosal tissue relaxation, while activated eNOS may facilitate attainment and maintenance of full erection.")
Thus I believe that when we do PE, we are causing shear stress on the endothelial cells, INDEPENDENTLY of the nervous system, which results in increased NO production causing smooth muscle cells to be relaxed. This smooth muscle cell relaxation is independent of the nervous system, unlike in a normal erection. Importantly, smooth muscle cells need to be relaxed in order to proliferate..
See: Regulation and characteristics of vascular smooth muscle cell phenotypic diversity - PMC where they say "Moreover, synthetic and contractile SMCs have different proliferative and migratory characteristics. Generally, synthetic SMCs exhibit higher growth rates and higher migratory activity than contractile SMCs" (synthetic is another word for relaxed)
This increased shear stress from PE is what causes smooth muscle cell proliferation, and smooth muscle cell production of collagen. However I think it is also important that when we do PE, that we are also stretching the lining of the CC, which is the tunica albugenia
Let me know what you think if you could!