Which specific organs are innervated by the uterovaginal plexus?

The uterovaginal plexus (plexus uterovaginalis) innervates the vagina, uterus, internal parts of the uterine tubes, and urinary bladder.

What sensory (afferent) fibers pass through the inferior hypogastric plexus?

Afferent visceral sensory fibers traveling from internal organs pass through the inferior hypogastric plexus (plexus hypogastricus inferior). This includes nociceptive and proprioceptive afferents from the bladder wall that respond to stretch.

Which spinal cord segments give rise to preganglionic fibers of the pelvic splanchnic nerves?

The pelvic splanchnic nerves (nn. splanchnici pelvici) receive parasympathetic preganglionic fibers from the sacral spinal cord, specifically segments S2–S4 (and S3–S5).

What fiber types form the inferior hypogastric plexus?

It is formed by sympathetic fibers (lumbar and sacral splanchnic nerves) and parasympathetic fibers (pelvic splanchnic nerves).

Where is the superior hypogastric plexus located?

The plexus is located at the level of the aortic bifurcation, anterior to the L5–S1 vertebral bodies.

Which ganglia form the sacral part of the sympathetic trunk?

The sacral part includes 3–4 sacral ganglia (ganglia sacralia), with the right and left trunks uniting inferiorly into a single unpaired ganglion (ganglion impar).

Pelvic Autonomic Plexuses: Anatomy, Parts and Pathways

Sympathetic and Autonomic Plexuses of the Pelvis

Plexus hypogastricus

For medical students2 min readUpdated 2026-10-10

Pelvic autonomic plexuses form a complex network of nerve fibers providing autonomic innervation to the pelvic organs. This system is primarily based on the lumbar and sacral sympathetic trunks, as well as major hypogastric plexuses that divide into secondary plexuses for specific organs.

Lumbar ganglia3 to 5 ganglia within the lumbar portion of the sympathetic trunk.

Trunk convergenceRight and left sympathetic trunks unite inferiorly to form the unpaired ganglion impar.

Key landmarkThe superior hypogastric plexus lies at the level of the aortic bifurcation.

Fiber compositionThe inferior hypogastric plexus contains both sympathetic and parasympathetic pathways.

Lumbar and Sacral Parts of the Sympathetic Trunk

Autonomic innervation of the pelvic region begins with the lower parts of the sympathetic trunk.

The lumbar part includes three to five lumbar ganglia (ganglia lumbalia). Important communicating branches arise from these structures. First, gray rami communicantes (rr. communicantes grisei) run to the lumbar spinal nerves. Second, lumbar splanchnic nerves (nn. splanchnici lumbales) carry sympathetic fibers directly to the abdominal aortic and hypogastric plexuses.

The sacral part of the sympathetic trunk has a distinct topography: it lies on the pelvic (anterior) surface of the sacrum, positioned medially to the anterior sacral foramina. This region typically contains 3 to 4 sacral ganglia (ganglia sacralia). An important anatomical feature is that inferiorly, the right and left sympathetic trunks converge to form a single unpaired ganglion — the ganglion impar. Sacral splanchnic nerves (nn. splanchnici sacrales) originate from the sacral ganglia and run to the autonomic plexuses of the lesser pelvis, supplementing them with sympathetic fibers.

Superior Hypogastric Plexus

The superior hypogastric plexus (plexus hypogastricus superior) is the direct anatomical continuation of the abdominal aortic plexus.

Topographically, this large plexus is located in a precise zone: at the level of the aortic bifurcation, descending anterior to the bodies of the fifth lumbar and first sacral vertebrae (L5–S1). As it descends into the pelvic cavity, this plexus divides into two symmetrical parts — the right and left inferior hypogastric plexuses (plexus hypogastricus inferior).

Inferior Hypogastric (Pelvic) Plexus

The inferior hypogastric plexus (plexus hypogastricus inferior, or plexus pelvicus) is the largest autonomic plexus in the lesser pelvis.

It is mixed in composition, formed by two types of nerve fibers:

Sympathetic fibers: supplied by the lumbar and sacral splanchnic nerves (nn. splanchnici lumbales et sacrales).
Parasympathetic fibers: supplied by the pelvic splanchnic nerves (nn. splanchnici pelvici).

The main function of the pelvic plexus is to innervate the pelvic viscera. Additionally, fibers from this prominent network actively contribute to smaller, secondary (organ-specific) plexuses.

Derived Pelvic Plexuses

Nerve branches extend from the inferior hypogastric plexus to specific organs, forming specialized secondary plexuses around them. Depending on sex, the composition of these plexuses exhibits specific anatomical features.

Main derivatives of the pelvic plexus:

Vesical plexus (plexus vesicalis) — innervates the urinary bladder.
Prostatic plexus (plexus prostaticus) — present exclusively in males.
Ductus deferens plexus (plexus deferentialis) — also exclusive to the male reproductive system.
Uterovaginal plexus (plexus uterovaginalis) — formed in females to innervate the corresponding reproductive organs.
Superior and inferior rectal plexuses (plexus rectalis superior et inferior) — supply the rectum.

Frequently asked questions

Which specific organs are innervated by the uterovaginal plexus?: The uterovaginal plexus (plexus uterovaginalis) innervates the vagina, uterus, internal parts of the uterine tubes, and urinary bladder.
What sensory (afferent) fibers pass through the inferior hypogastric plexus?: Afferent visceral sensory fibers traveling from internal organs pass through the inferior hypogastric plexus (plexus hypogastricus inferior). This includes nociceptive and proprioceptive afferents from the bladder wall that respond to stretch.
Which spinal cord segments give rise to preganglionic fibers of the pelvic splanchnic nerves?: The pelvic splanchnic nerves (nn. splanchnici pelvici) receive parasympathetic preganglionic fibers from the sacral spinal cord, specifically segments S2–S4 (and S3–S5).
What fiber types form the inferior hypogastric plexus?: It is formed by sympathetic fibers (lumbar and sacral splanchnic nerves) and parasympathetic fibers (pelvic splanchnic nerves).
Where is the superior hypogastric plexus located?: The plexus is located at the level of the aortic bifurcation, anterior to the L5–S1 vertebral bodies.
Which ganglia form the sacral part of the sympathetic trunk?: The sacral part includes 3–4 sacral ganglia (ganglia sacralia), with the right and left trunks uniting inferiorly into a single unpaired ganglion (ganglion impar).

Go deeper

Gray rami communicantes of the lumbar region
Parasympathetic pelvic splanchnic nerves
Sexual dimorphism of secondary pelvic plexuses
Connection between the superior hypogastric and abdominal aortic plexuses