Inferior hypogastric plexus

The inferior hypogastric plexus is a paired autonomic nerve plexus innervating organs of the pelvic cavity. It gives rise to the prostatic plexus in males and the uterovaginal plexus in females.

Anatomy

Structure

The plexus consists of an irregular, fenestrated layer containing small ganglia.

Relations

The inferior hypogastric plexus is situated in the sagittal plane just outside the peritoneum, between the anterior sacral foramina, and the posterior aspect of the urinary bladder. It is situated lateral to the rectum and vagina, and medial to the internal iliac artery and internal iliac vein of either side.

Afferents

hypogastric nerve – a continuation of either superior hypogastric plexus.
sacral splanchnic nerves
pelvic splanchnic nerves also contribute parasympathetic efferent fibers to the plexus.

Efferents

Efferents branches form secondary plexuses that accompany the internal iliac artery along its course. They give rise to the middle and inferior rectal plexuses, vesical plexus, deferential plexus, and prostatic plexus or uterovaginal plexus. Efferents of the plexus are responsible for innervating the genital erectile tissues.

Clinical significance

Due to its location, injury to this structure can arise as a complication of pelvic surgeries and may cause urinary dysfunction and urinary incontinence. Testing of bladder function is used in that case to show a poorly compliant bladder, with bladder neck incompetence, and fixed external sphincter tone.