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.

Summary

• origin: anterior division of internal iliac artery
• location: pelvis, gluteal region, perineum
• supply: perineum, genitalia, anal region, erectile tissues
• branches: inferior rectal artery, deep artery of the penis/ clitoris, dorsal artery of the penis/ clitoris, perineal artery, posterior scrotal artery, transverse perineal artery, artery to the bulb

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

It pierces the parietal pelvic fascia to exit the pelvis. It passes through the greater sciatic foramen inferior to the piriformis muscle to enter the gluteal region. It then curves around 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(Alcock’s canal) with with the internal pudendal veins and the pudendal nerve. It then runs in the lateral wall of the ischioanal fossa and the perineal region.  

Branches

It gives off an inferior rectal branch as it travels through the posterior part of the pudendal canal. The inferior rectal artery supplies the rectum along with the middle rectal and superior rectal artery. It also gives off a perineal branch, which splits into the posterior scrotal artery and the transverse perineal artery. Further anteriorly it gives an artery to the bulb, which enters the corpus spongiosum.

Termination

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

Supply

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