Anatomy, Abdomen and Pelvis: Inferior Hypogastric Plexus

Excerpt

The inferior hypogastric plexus is also known as the pelvic ganglion. Classic anatomical studies have provided few details of the inferior hypogastric plexus morphology or the location and nature of the associated nerves. The fusion of the pelvic splanchnic nerves, sacral splanchnic nerves, and superior hypogastric plexus along with visceral afferent fibers forms the inferior hypogastric plexus. There have also been studies showing the contribution of spinal nerves S2-S5 to the inferior hypogastric plexus.

Dissection of the inferior hypogastric plexus is difficult due to its location, the multiplicity of its sympathetic and parasympathetic roots, and the complex distribution of its terminal branches. The density of surrounding connective tissue also precludes the pelvic-perineal anatomy; therefore, it is difficult to determine the exact relationship between the nerves and pelvic connective tissue. The inferior hypogastric plexus lends its clinical relevance to various urogenital pain syndromes, including endometriosis, prostatitis, and chronic pain of the sacral region, postherpetic neuralgia, and rectal pain, among others. Therefore, any surgical procedure in this anatomical region must be met with due diligence, with respect to the underlying plexus that may be inadvertently damaged, thus causing a slew of related symptoms of the urogenital tract as well compromise of the pelvic autonomic innervation.