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Autonome Innervation des weiblichen Beckens

Anatomische Grundlagen

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Zusammenfassung

Die autonome Innervation des kleinen Beckens wird durch den Plexus hypogastricus inferior gewährleistet. Dieser wird von sympathischen (Rr. hypogastricus dexter et sinister, sakraler Grenzstrang) und parasympathischen Zuflüssen (Nn. splanchnici pelvici) gespeist und nimmt die Funktion eines Verteilernetzes vegetativer Nerven für die Beckenorgane auf. Die einheitliche, vegetative Nervenplatte liegt beidseits tief im kleinen Becken in der Sakrogenitalfalte medial der Gefäßplatte der Vasa iliaca interna. Die Organversorgung erfolgt durch direkte Nervenfasern aus dem Plexus hypogastricus inferior, die anterolateral am Darm und von inferolateral sowie laterodorsal an Blase und weiblichem Genitale ansetzen. Komplettiert wird diese Innervation durch Nervenfasern, die sich den Arterien und dem Ureter beim Durchziehen des Plexusgebietes anlegen und sie im terminalen Verlauf zum Organ begleiten. Dieses Wissen um den Plexus hypogastricus inferior lässt Prädilektionsstellen iatrogener Plexusläsion erkennen.

Abstract

The pelvic plexus with its sympathetic (hypogastric nerves, sacral sympathetic trunk) and parasympathetic (pelvic splanchnic nerves) sources provides and distributes the autonomic nervous supply for the pelvic organs. This homogeneous autonomic nerve plate is located within and deeply to the peritoneal fold (recto-uterine in the female pelvis) lying medially to the internal iliac vessels. Autonomic nerve fibres emerge from the pelvic plexus and travel to the anterolateral aspect of the rectum and the inferolateral and posterolateral aspects of the bladder and female genital tract. In addition, pelvic organs are innervated by nerves accompanying the vessels and the ureter which penetrate the pelvic plexus. Knowledge of the topography of the pelvic plexus indicates the most common sites for iatrogenic lesions and should help us in avoiding postoperative autonomic dysfunction.

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Authors and Affiliations

  1. Anatomie und Zelluläre Neurobiologie der Universität Ulm

    B. Baader & M. Herrmann

  2. Anatomisches Institut—Anatomie und Zellbiologie—der Universität Bonn

    S. L. Baader

  3. Klinik für Urologie der Universität Tübingen

    A. Stenzl

  4. Triererstraße 55, 53115, Bonn

    B. Baader

Authors
  1. B. Baader
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  2. S. L. Baader
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  3. M. Herrmann
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  4. A. Stenzl
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Correspondence to B. Baader.

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Baader, B., Baader, S.L., Herrmann, M. et al. Autonome Innervation des weiblichen Beckens. Urologe [A] 43, 133–140 (2004). https://doi.org/10.1007/s00120-003-0499-9

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  • DOI: https://doi.org/10.1007/s00120-003-0499-9

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