The superior hypogastric plexus (in older texts, hypogastric plexus or presacral nerve) is a

plexus In neuroanatomy, a plexus (from the Latin term for "braid") is a branching network of vessels or nerves. The vessels may be blood vessels (veins, capillaries) or lymphatic vessels. The nerves are typically axons outside the central nervous system ...

nerve A nerve is an enclosed, cable-like bundle of nerve fibers (called axons) in the peripheral nervous system. A nerve transmits electrical impulses. It is the basic unit of the peripheral nervous system. A nerve provides a common pathway for the ...

s situated on the vertebral bodies anterior to the bifurcation of the

abdominal aorta In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax). Structure The abdominal aorta begins at the level of the diaphr ...

Structure

From the plexus, sympathetic fibers are carried into the pelvis as two main trunks- the right and left hypogastric nerves- each lying medial to the

internal iliac artery The internal iliac artery (formerly known as the hypogastric artery) is the main artery of the pelvis. Structure The internal iliac artery supplies the walls and viscera of the pelvis, the buttock, the reproductive organs, and the medial comp ...

and its branches. The right and left hypogastric nerves continues as

Inferior hypogastric plexus The inferior hypogastric plexus (pelvic plexus in some texts) is a network () of nerves that supplies the organs of the pelvic cavity. The inferior hypogastric plexus gives rise to the prostatic plexus in males and the uterovaginal plexus in femal ...

; these hypogastric nerves send sympathetic fibers to the ovarian and ureteric plexuses, which originate within the

renal The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about in length. They receive blood from the paired renal arteries; bloo ...

and

abdominal aortic In human anatomy, the abdominal aorta is the largest artery in the abdominal cavity. As part of the aorta, it is a direct continuation of the descending aorta (of the thorax). Structure The abdominal aorta begins at the level of the diaphragm ...

sympathetic plexuses. The superior hypogastric plexus receives contributions from the two lower

lumbar splanchnic nerves The lumbar splanchnic nerves are splanchnic nerves that arise from the lumbar part of the sympathetic trunk and travel to an adjacent plexus near the aorta. They originate from L1 and L2. These nerves contain preganglionic sympathetic and gener ...

(L3-L4), which are branches of the chain ganglia. They also contain parasympathetic fibers which arise from

pelvic splanchnic nerve Pelvic splanchnic nerves or nervi erigentes are splanchnic nerves that arise from sacral spinal nerves S2, S3, S4 to provide parasympathetic innervation to the organs of the pelvic cavity. Structure The pelvic splanchnic nerves arise from th ...

(S2-S4) and ascend from

; it is more usual for these parasympathetic fibers to ascend to the left-handed side of the superior hypogastric plexus and cross the branches of the sigmoid and left colic vessel branches, as these parasympathetic branches are distributed along the branches of the

inferior mesenteric artery In human anatomy, the inferior mesenteric artery, often abbreviated as IMA, is the third main branch of the abdominal aorta and arises at the level of L3, supplying the large intestine from the distal transverse colon to the upper part of the a ...

. The SHP is the continuation of the

abdominal aortic plexus The abdominal aortic plexus (not to be confused with the thoracic aortic plexus) is formed by branches derived, on either side, from the celiac plexus and ganglia, and receives filaments from some of the lumbar ganglia. It is situated upon the sid ...

Clinical significance

Presacral neurectomy is a laparoscopic procedure where superior hypogastric plexus is excised, so that the pain pathway is cut off from the spinal column. This procedure is done to manage chronic pelvic pain when conservative medical therapy fails.

Structure

Clinical significance

Additional images

References

External links