Internal pudendal artery

The internal pudendal artery is a branch of the anterior division of the internal iliac artery and is the primary supply of the perineum. It is a larger vessel in males than in females and is usually the smallest branch of the anterior division of the internal iliac artery.

Summary

• origin: anterior division of internal iliac artery

• location: pelvis, gluteal region, perineum

• supply: perineum, genitalia, anal region, erectile tissues

• branches: inferior rectal artery, perineal artery, artery to the bulb, deep artery of the penis/clitoris, dorsal artery of the penis/clitoris

Gross anatomy

Origin

The internal pudendal artery branches from the anterior division of the internal iliac artery, in front of the inferior gluteal artery.

Course

The vessel courses through several compartments on its way to the perineum, starting by piercing the parietal pelvic fascia to exit the pelvis. It courses through the greater sciatic foramen inferior to the piriformis muscle to enter the gluteal region and then curves around the posterior aspect of the ischial spine and sacrospinous ligament to re-enter the pelvis by passing through the lesser sciatic foramen. It then re-exits the pelvis through the pudendal canal with the internal pudendal veins and the pudendal nerve. It then runs in the lateral wall of the ischioanal fossa and the perineal region where it gives several branches.  

Branches

Inferior rectal artery, perineal and urethral arteries are present in both sexes. The inferior rectal branch as it travels through the posterior part of the pudendal canal which supplies the lower rectum by anastomosing with the contralateral inferior rectal artery and the middle rectal and superior rectal arteries.

In females, in branches into artery into bulb of vestibule, deep artery of clitoris and dorsal artery of clitoris. In males, it branches into deep artery of penis, dorsal artery of penis and artery to bulb of penis ⁵.

Termination

The internal pudendal artery passes medial to the ischial tuberosity to exit the pudendal canal and divides into two terminal branches at the anterior angle of the perineal membrane, the deep and dorsal arteries of the penis/clitoris.

Supply

The vessel is the primary supply of the perineum. It supplies the skin and muscles of the anal triangle and urogenital triangle, as well as associated erectile bodies. It also contributes to the supply of the rectum.