Internal pudendal arteries

Endovascular
treatment of a post-traumatic priapism case. Left arterio-cavernous fistula (circle) originating from the left cavernosal artery (black arrow). Large white arrows: Internal pudendal artery; White arrowhead: Perineal scrotal artery; Thin white arrow: Penile artery; Black arrowhead: Dorsal artery of penis.
www.eurorad.org • CC by-nc-sa-4.0
Endovascular
treatment of a post-traumatic priapism case. Left arterio-cavernous fistula (circle) originating from the left cavernosal artery (black arrow). Large white arrows: Internal pudendal artery; White arrowhead: Perineal scrotal artery; Thin white arrow: Penile artery; Black arrowhead: Dorsal artery of penis.
www.eurorad.org • CC by-nc-sa-4.0
Endovascular
treatment of a post-traumatic priapism case. No collateral branches feeding the fistula (circle) are identifiable. Black arrow: Cavernosal artery; Large white arrows: Internal pudendal artery; White arrowhead: Perineal scrotal artery; Thin white arrow: Penile artery; Black arrowhead: Dorsal artery of penis.
www.eurorad.org • CC by-nc-sa-4.0
Radiopaedia • CC-by-nc-sa 3.0 • de

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

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 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. After the perineal artery, it is known as the common penile artery, which has 3 branches:

  • artery to the bulb or bulbourethral artery, which enters the corpus spongiosum after piercing the perineal membrane
  • dorsal artery of the penis, which runs along the dorsal surface of the penis
  • cavernosal artery of the penis
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.