The internal pudendal artery, orarteria pudenda interna, is a key blood vessel in the human pelvis that supplies blood to the perineum and external genitalia. Originating from the internal iliac artery, it plays an essential role in maintaining the vascular supply of structures involved in urination, sexual function, and defecation. The branches of the internal pudendal arteryramas de la arteria pudenda internaare numerous and serve highly specialized functions. A thorough understanding of these branches is important not only for anatomists and surgeons but also for anyone studying the vascular anatomy of the pelvis and perineum.
Origin and Path of the Internal Pudendal Artery
Origin from the Internal Iliac Artery
The internal pudendal artery arises from the anterior division of theinternal iliac artery, which is the main blood supply to the pelvic organs. After its origin, the internal pudendal artery exits the pelvic cavity through thegreater sciatic foramen, curves around the sacrospinous ligament, and re-enters the pelvis via thelesser sciatic foramen.
Path Through the Pudendal Canal
Once it re-enters the pelvic floor, the artery travels within thepudendal canal (Alcock’s canal)a fascial tunnel in the lateral wall of the ischioanal fossa alongside the pudendal nerve and the internal pudendal vein. As it courses forward in the perineum, the artery gives off several terminal and collateral branches that serve the skin, muscles, and organs in this region.
Main Branches of the Internal Pudendal Artery
The branches of the internal pudendal artery can be classified based on their destinations and the tissues they supply. The following are the keyramas de la arteria pudenda internathat arise during its course:
1. Inferior Rectal Arteries (Arterias rectales inferiores)
These arteries branch off early in the perineal segment of the internal pudendal artery and travel medially to supply the lower part of the rectum and the anal canal.
- Supply the external anal sphincter
- Support perianal skin and mucosa
- Communicate with branches of the middle and superior rectal arteries
The inferior rectal arteries are important in maintaining the vascular integrity of the anal region and are often involved in hemorrhoidal conditions.
2. Perineal Artery (Arteria perineal)
The perineal artery arises within the pudendal canal and provides blood to the superficial structures of the perineum. It courses anteriorly and inferiorly, giving off smaller branches to nearby muscles and skin.
- Supplies the superficial transverse perineal muscle
- Supplies the posterior scrotum in males or labia in females
- Contributes to the vascular network of the perineal body
This artery plays a role in maintaining perfusion to the structures involved in continence and sexual function.
3. Artery of the Bulb (Arteria del bulbo del pene o del vestíbulo)
This branch travels medially toward the bulb of the penis in males or the vestibular bulb in females. It enters the corpus spongiosum and contributes to the blood supply of the urethral tissues.
- In males: supplies the bulb of the penis and the proximal spongy urethra
- In females: supplies the vestibular bulbs and greater vestibular glands
This artery is essential for erectile tissue function and supports genital sensitivity and health.
4. Urethral Artery (Arteria uretral)
This artery is not always present as a separate branch but may arise from the artery of the bulb or the dorsal artery. When present, it enters the corpus spongiosum and follows the course of the urethra.
- Supplies the penile or vaginal urethra
- Supports mucosal integrity and lubrication
5. Deep Artery of the Penis or Clitoris (Arteria profunda del pene o del clítoris)
This is a terminal branch that enters the corpus cavernosum and runs centrally through the erectile tissue. It is key to the physiological mechanism of erection.
- Runs within each corpus cavernosum
- Fills the erectile tissue with blood during arousal
- Responds to neural and hormonal stimulation
This artery is a vital component of the vascular system that enables penile or clitoral erection and sexual function.
6. Dorsal Artery of the Penis or Clitoris (Arteria dorsal del pene o del clítoris)
The dorsal artery is the other main terminal branch of the internal pudendal artery. It passes along the dorsum of the penis or clitoris and lies between the deep dorsal vein and the dorsal nerve.
- Supplies the skin and fascial layers of the penis or clitoris
- Contributes to blood flow to the glans
- Important for both tactile sensitivity and vascular health
This artery complements the deep artery by supporting superficial and cutaneous genital perfusion.
Additional Minor Branches and Variations
In some individuals, small unnamed branches may arise from the internal pudendal artery to supply adjacent structures such as the urethral sphincter, pelvic floor muscles, and external genital skin. The presence and course of these branches can vary, making surgical navigation of this region a highly skilled task.
Clinical Relevance of the Internal Pudendal Artery and Its Branches
Implications in Surgery
Knowledge of the branches of the internal pudendal artery is essential during surgical procedures in the perineum, such as episiotomy, perineal repair, prostatectomy, and reconstructive surgeries. Accidental injury to these vessels can lead to significant bleeding or postoperative complications.
Pudendal Nerve Block
The artery serves as an important landmark during pudendal nerve block, a technique used for pain relief during childbirth or minor perineal surgeries. The close anatomical relationship between the artery and nerve requires precise anatomical knowledge to avoid vascular injury.
Sexual Dysfunction and Erectile Disorders
Blockage, trauma, or congenital malformations affecting the deep or dorsal arteries of the penis or clitoris can contribute to sexual dysfunction. Vascular insufficiency is one of the leading causes of erectile dysfunction in men, and understanding the course of these arteries is crucial in diagnostic and therapeutic procedures like penile Doppler studies or vascular surgery.
Hemorrhoids and Anal Surgery
Since the inferior rectal branches supply the lower rectum and anal canal, they are directly involved in the development of external hemorrhoids. Careful attention to these vessels during surgery helps reduce postoperative bleeding and complications.
Theramas de la arteria pudenda internaform a complex and highly specialized vascular network that serves the perineum, external genitalia, anal canal, and associated muscles. These branches ranging from the inferior rectal and perineal arteries to the deep and dorsal arteries of the penis or clitoris are vital for maintaining urogenital health, sexual function, and pelvic floor integrity. Their anatomical pathways reflect the complexity of the pelvic region, and their clinical importance cannot be overstated. A thorough understanding of this arterial system is indispensable for professionals in surgery, urology, gynecology, and emergency medicine.