Mrq. Davies, ANATOMY OF THE NERVE SUPPLY OF THE RECTUM, BLADDER, AND INTERNAL GENITALIA IN ANORECTAL DYSGENESIS IN THE MALE, Journal of pediatric surgery, 32(4), 1997, pp. 536-541
Using a posterior sagittal approach to expose retroperitoneal viscera
and nerves, the anatomy of the pelvic autonomic nerve plexus was studi
ed in normal and abnormal male cadaver specimens. This plexus is found
on the anterolateral surface of the lower rectum surrounded by endope
lvic fascia. The autonomic nerves that supply the plexus reach it from
posterior, lateral to the midline by passing over the surface of the
rectum, The nerves of this plexus are distributed with the terminal br
anches of the internal iliac arteries, mainly with the vessels of the
inferior vesical plexus. The rectum receives its autonomic nerves with
its arterial blood supply, the superior rectal artery. The nerves of
the pelvic plexus supply the genitourinary viscera that lie anterior t
o the rectum and in front of the fascia of Denonvilliers. The named fa
scial layers of the pelvis play a major role in determining the anatom
ic plane of these structures. In anorectal agenesis the plexus becomes
a more midline structure, Because the pelvic fascia is often deficien
t in these cases these nerves lie vulnerable to inappropriate midline
dissection. Copyright (C) 1997 by W.B. Saunders Company.