Abstract
This innervation is extremely important, not only due to its density but also due to the major role it plays in sexual life. It consists of a double innervation, which is, on the one hand, cerebrospinal and, on the other hand, vegetative. The pudendal nerve (shameful nerve), cerebrospinal contingent, is the key component and has therefore been referred to as “king of the perineum” (R. Robert et al.). However, it is not the only nerve structure to be involved. The other key nerve contingent is the vegetative contingent, originating from the inferior hypogastric plexus: the cavernous nerve of the clitoris. Such as will be noted in the following sections, the two components converge and meet to ensure the extraordinary innervation of the bulbo-clitoral organ.
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Notes
- 1.
The central nerve system (whose centres are cortical) is dependent on the conscience and will. The vegetative or autonomous system, which is independent of the conscience and will, ensures the operation of the organs.
- 2.
The potential compression areas are located in the space between the sacrotuberous and sacro-spinous ligaments, at the level of the falciform process and, lastly, in the pudendal canal. (Alcock’s canal). See R. Robert et al, Neurosurgery, 55, 453–469.
- 3.
The termination of the pudendal nerve can also be located before the penetration in the pudendal canal, above the ischial tuberosity.
- 4.
The ortho- and parasympathetic fibres (whose actions are antagonistic) especially control the motricity of the vessels, the smooth muscles, the viscera and the glands.
- 5.
When the bulbo-clitoral organ is unstuck from the pubis, the 2 dorsal nerves of the clitoris remain covered by their “fibrous cape” and there is no risk of lesion. On the other hand, the cavernous nerves, which benefit from a reduced protection at this level, are likely to be injured due to stretching if surgical operations are not carried out with precaution and care.
- 6.
The “bulbar nerve”, term used by many authors, is an inadequate term because it leads to confusion: It is normally used to refer to the somatic branches of the deep perineal nerve, dedicated to the spongious bulb. Moreover, the term of nerve evokes a well-structured nerve structure, such as is the case for the cavernous nerve, whereas it actually concerns, for these bulbar vegetative fibres, superimposed thin rami.
- 7.
The pathways of the vegetative nervous system, whether they belong to the ortho- or parasympathetic contingent, are all bi-neuronal, with a first neuron, the protoneuron, which departs from the spinal centre and is articulated with a second neuron, the deutoneuron, which ends at the effector organ. The synapse between the 2 neurons occurs at a different site for each of the 2 contingents.
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Di Marino, V., Lepidi, H. (2014). Innervation of the Bulbo-clitoral Organ. In: Anatomic Study of the Clitoris and the Bulbo-Clitoral Organ. Springer, Cham. https://doi.org/10.1007/978-3-319-04894-9_8
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DOI: https://doi.org/10.1007/978-3-319-04894-9_8
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