Quick Facts
Origin: Formed by and passes between the superior hypogastric plexus and the inferior hypogastric plexus.
Course: Passes along the anterior surface of the sacrum on both sides of the midline.
Branches: Contributes to the ureteric and the gonadal plexuses. In addition, it may send branches along plexuses that accompany the internal iliac artery and its branches. Some fibers peel off to supply the sigmoid colon.
Supply: Sigmoid colon, inferior end of the ureter, gonads, middle and inferior rectum, bladder, prostate (males), or uterus and vagina (females).
Origin
Sympathetic preganglionic nerve cells are located in first and second lumbar (L1 and L2) spinal cord segments and form the lumbar splanchnic nerves. They synapse on cells in the inferior mesenteric ganglion, but also on small collections of cell bodies in the aortic and superior hypogastric plexuses. The postganglionic nerve axons emerge from these sites and pass through the superior hypogastric plexus. The fibers then converge as the descending axons of the hypogastric nerves. Preganglionic parasympathetic cells at the second to fourth sacral (S2-S4) spinal cord levels exit and form pelvic splanchnic nerves. Those that pass through the inferior hypogastric plexus converge to form the ascending component of the hypogastric nerve. Finally, there are preganglionic sympathetic fibers that descend from first and second lumbar nerve (L1 and L2) down the sympathetic trunk to exit at the second to fourth sacral (S2-S4) levels.
Course
Paired hypogastric nerves travel on both sides of the midline on the anterior surface of the fused sacral vertebral bodies, bridging between the superior (unpaired) and inferior (paired) hypogastric plexuses.
Branches
The hypogastric nerve connects the superior and inferior hypogastric plexuses.
Supplied Structures
Some ascending, parasympathetic innervation of the hindgut (superior rectum, sigmoid, descending, and distal half to one third of the transverse colon), though this is mostly through the plexus of the superior rectal artery. Descending sympathetic innervation of the pelvis including the inferior ureter and bladder, rectum, prostate gland, ductus deferens, and testes (males), or uterus, vagina, and ovaries (females).
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Hypogastric Nerve
The hypogastric nerve is basically composed of preganglionic fibers that innervate principal and accessory pelvic ganglia, and originates the hypogastric plexus (Kolbeck and Steers, 1993;
