Pelvic (inferior hypogastric plexus) intramural ganglia
Ganglion · Inferior hypogastric plexus S2–S4 input
Pelvic splanchnic nerves synapse in ganglia scattered through the inferior hypogastric (pelvic) plexus on the pelvic side wall and within the walls of the bladder, rectum, uterus and erectile tissue. Fibres for the descending and sigmoid colon ascend through the hypogastric nerves to synapse in the hindgut wall.
Traced from the start
- Parasympathetic (craniosacral) outflow
- Sacral parasympathetic outflow S2–S4 (pelvic splanchnic nerves)
- Pelvic (inferior hypogastric plexus) intramural ganglia
Detail
- Location
- Either side of the rectum, alongside the seminal vesicles or uterine cervix — within reach of pelvic surgery
- Hindgut extension
- Preganglionic fibres ascend via hypogastric nerves and superior hypogastric plexus to ganglia in the descending and sigmoid colon
- Cavernous nerves
- Leave the plexus beside the prostate to reach the corpora cavernosa
When it goes wrong
Failure of neural crest cells to migrate into the distal bowel wall (Hirschsprung disease, RET mutations)
Aganglionic rectosigmoid segment stays contracted: failure to pass meconium within 48 hours, abdominal distension and bilious vomiting; rectal biopsy shows absent ganglion cells with hypertrophied nerve trunks
Radical prostatectomy, abdominoperineal resection or radical hysterectomy damaging the pelvic plexus
Erectile dysfunction and bladder dysfunction (retention or poor emptying) from loss of parasympathetic supply
Practise this structure
1 question in the bank tagged Autonomic.