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Internal pudendal artery

Last revised by Assoc Prof Craig Hacking on 14 Sep 2021

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 IIA.

Summary

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

The internal pudendal artery gives off an 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. It also gives off a perineal branch which is different between females and males.

Termination

The internal pudendal artery passes medial to the ischial tuberosity to exit the pudendal canal and divides into the deep and dorsal arteries of the penis/clitoris, its terminal branches.

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

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Cases and figures

  • Figure 1: branches of the IPA (Gray's illustrations)
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  • Figure 2: branches of the IPA (Gray's illustrations)
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  • Figure 3: arterial supply to the penis (Gray's illustration)
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