The internal pudendal artery, orla arteria pudenda internain Spanish, plays a vital role in supplying blood to the external genitalia and perineal structures in both males and females. Despite its relatively small size, it is one of the most important arteries in the pelvic region due to the sensitive and highly vascularized areas it nourishes. The internal pudendal artery arises from a larger artery and follows a specific path through the pelvis to reach the perineum. Understanding its anatomy, branches, and function is essential in fields such as medicine, surgery, and anatomy education, especially in topics related to urology, gynecology, and colorectal health.
Origin and Pathway of the Internal Pudendal Artery
The internal pudendal artery typically originates from the internal iliac artery, which is a major artery supplying the pelvis. This origin is consistent in most anatomical cases, although some variations can occur.
Course Through the Pelvis
After arising from the internal iliac artery, the internal pudendal artery exits the pelvic cavity through the greater sciatic foramen, typically below the piriformis muscle. It then curves around the sacrospinous ligament and re-enters the pelvis through the lesser sciatic foramen. From there, it enters the pudendal canal, also known as Alcock’s canal, where it travels along with the pudendal nerve and internal pudendal vein toward the perineum.
This anatomical journey ensures that the artery reaches the perineal region while staying protected within muscular and ligamentous structures, which helps reduce the risk of injury.
Main Branches of the Internal Pudendal Artery
Once it enters the perineum, the internal pudendal artery gives off several branches that supply various pelvic and perineal structures. These include:
- Inferior rectal artery– Supplies the lower part of the anal canal and external anal sphincter.
- Perineal artery– Provides blood to the skin and superficial muscles of the perineum.
- Artery to the bulb– Supplies the bulb of the penis or the vestibular bulb in females.
- Urethral artery– Feeds the urethra and adjacent tissues.
- Deep artery of the penis or clitoris– Penetrates the corpora cavernosa to support erectile function.
- Dorsal artery of the penis or clitoris– Travels along the dorsum of the penis or clitoris and supplies the overlying skin and glans.
Each of these branches plays a specific role in providing oxygenated blood to tissues critical for urination, defecation, reproduction, and sexual function.
Functions and Importance
The primary role of the internal pudendal artery is to ensure adequate blood supply to the perineum and external genitalia. Its function is essential for maintaining tissue health, supporting immune defense, and enabling proper function of the organs it supplies.
Support for Sexual Function
In both men and women, the internal pudendal artery contributes directly to sexual function. Its branches are involved in supplying the erectile tissues such as the corpus cavernosum and bulbospongiosus. In men, disruption of this artery can affect erectile function, making it a significant structure in erectile dysfunction research and treatment.
Contribution to Urinary and Fecal Continence
The muscles and sphincters involved in controlling urination and defecation are also supported by branches of the internal pudendal artery. An adequate blood supply helps maintain muscle tone and responsiveness in the anal and urethral sphincters, playing a vital role in continence.
Support in Childbirth
In women, this artery supports the perineum during labor and delivery. Damage or compression of the internal pudendal artery during childbirth can lead to perineal pain or complications in postpartum healing. Understanding its location helps in procedures like pudendal nerve block, commonly used to relieve pain during labor.
Clinical Significance
Due to its location and function, the internal pudendal artery is significant in various medical contexts. Its knowledge is critical during pelvic surgeries, trauma care, and vascular interventions.
Arterial Injury
Pelvic fractures, deep perineal trauma, or surgical interventions near the rectum or urogenital region can damage the internal pudendal artery. Such injuries may result in hematomas, excessive bleeding, or compromised tissue function if not managed correctly.
Pudendal Neuralgia and Arterial Implication
Though the condition primarily affects the pudendal nerve, nearby blood vessels like the internal pudendal artery can sometimes contribute to nerve entrapment or compression. In such cases, surgical decompression or vascular repositioning may be required to relieve symptoms.
Endovascular Procedures
In certain conditions, like intractable pelvic hemorrhage or male impotence, interventional radiologists may target the internal pudendal artery for embolization or revascularization. These procedures require precise anatomical knowledge to avoid complications.
Use in Reconstructive Surgery
In plastic and reconstructive surgery, especially for genital or perineal repairs, the internal pudendal artery may be used as a vascular supply source for flaps and grafts. Its predictable anatomy makes it a reliable choice for microsurgical techniques.
Gender Differences
While the internal pudendal artery exists in both sexes and follows a similar path, its terminal branches vary slightly based on the anatomical structures they serve.
- In males, the artery supplies the penis, scrotum, and perineum.
- In females, it supplies the clitoris, labia, vestibule, and perineum.
These differences are essential to understand in gender-specific medical procedures, from surgeries to targeted nerve blocks.
Anatomical Relationships
The internal pudendal artery is accompanied by the pudendal nerve and internal pudendal vein throughout much of its course. These structures travel together within the pudendal canal and supply overlapping areas. Their close relationship makes them collectively important in neurovascular control of the pelvic region.
Other nearby structures include the:
- Sacrospinous ligament – Which the artery loops around
- Ischial spine – A landmark used to locate the artery during nerve block procedures
- Levator ani and coccygeus muscles – Pelvic floor muscles that lie near the artery’s course
Associated Nerve Blocks
Due to its role in innervating pain-sensitive areas, the internal pudendal artery’s location is used as a landmark for the pudendal nerve block. This block is employed for:
- Obstetric procedures such as episiotomy
- Pain management in chronic pelvic pain conditions
- Minor surgeries of the anus or external genitalia
The success of the block depends heavily on precise anatomical knowledge of the internal pudendal artery’s path and surrounding features.
La arteria pudenda interna, or the internal pudendal artery, is a small yet profoundly important blood vessel in the human body. It serves the pelvic and perineal regions, supplying vital blood flow to muscles, skin, reproductive organs, and sphincters. From supporting sexual function and continence to being a key landmark in surgery and nerve blocks, this artery’s role is essential in both health and disease. A strong understanding of its anatomy, branches, and clinical relevance allows healthcare professionals to diagnose, treat, and manage a wide variety of conditions more effectively. Though often overlooked, the internal pudendal artery remains one of the most functionally significant vessels in the pelvic vascular network.