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Clinical Anatomy
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Clinical Anatomy
Article . 2018 . Peer-reviewed
License: Wiley Online Library User Agreement
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Clinical Anatomy
Article . 2019
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The anatomy of the male inferior hypogastric plexus: What should we know for nerve sparing surgery

Authors: Raphael Röthlisberger; Valerie Aurore; Susanne Boemke; Hannes Bangerter; Mathias Bergmann; George N. Thalmann; Valentin Djonov;

The anatomy of the male inferior hypogastric plexus: What should we know for nerve sparing surgery

Abstract

The aim of this study was to investigate the nerve supply to the structures in the male lesser pelvis and review its clinical relevance, especially during nerve sparing surgery. Three formalin‐embalmed and 16 Thiel‐embalmed male hemipelves were used. They were microdissected after repeated treatments with nitric acid diluted 1:10 with milliQ‐water. The inferior hypogastric plexus (IHP) is a fan‐like structure lateral from the rectum on the fascia of the levator ani. Nerves emerging from the proximal, solid part of the plexus follow the internal iliacal vessels and reach the prostate from dorsolateral. The innervation of the urethra and the corpora cavernosa derives from two origins: one follows the ejaculatory duct and the seminal vesicle, reaching the proximal urethra and the prostate from dorsal; the other follows the inferior vesical artery to reach the prostate from lateral, and then forms the neurovascular bundle on both sides of the prostatic fascia, spreading to the pelvic floor muscles and the corpora cavernosa along with the distal urethra. A connection between the two parts was demonstrated in approximately one third of the samples investigated. The nerve supply to the urinary bladder, the urethra, and the corpora cavernosa emerges mainly from the IHP. The innervation of the proximal urethra and its autonomic muscular structures has a dorsal (ejaculatory duct) and lateral (inferior vesical artery) origin. To maintain good erectile and continence function it is important to save both the dorsal and lateral neurovascular roots. Clin. Anat. 31:788–796, 2018. © 2018 Wiley Periodicals, Inc.

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Keywords

Male, male urethra, nerve sparing, Urinary Bladder, seminal vesicles, Neurosurgical Procedures, Pelvis, Urethra, pelvic floor, Cadaver, Humans, lesser pelvis, hypogastric plexus, prostate, Hypogastric Plexus, Dissection, Penile Erection, Prostate, Seminal Vesicles, Pelvic Floor, microdissection, urinary bladder, Organ Sparing Treatments

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
21
Top 10%
Top 10%
Top 10%
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bronze