Cardiovascular system · Pelvis
Internal pudendal vein !
The internal pudendal veins travel with the internal pudendal artery and drain blood from the perineum and vulva back into the pelvis.
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What it is
The vein that runs with the internal pudendal artery.
What it does
Drains the perineum and vulva.
Key facts
- Drains
- Perineum, vulva, vestibular bulbs and clitoris (except the deep dorsal vein of the clitoris, which drains to the vesical plexus)
- Into
- Internal iliac vein
Relations
- Course
- From the perineum back through the pudendal canal → lesser sciatic foramen → around the ischial spine → greater sciatic foramen below the piriformis → internal iliac vein
- Medial
- Pudendal nerve at the ischial spine
- Lateral
- Obturator internus fascia, which forms the wall of the pudendal canal
- Superficial
- Sacrotuberous ligament and gluteus maximus where it crosses the ischial spine
How to find it
It cannot be felt. It is found with the internal pudendal artery behind the ischial spine in a gluteal approach, or in the pudendal canal on the lateral wall of the ischioanal fossa.
On imaging
Small paired veins, seen on contrast CT or MRI beside the internal pudendal artery in the pudendal canal on the side wall of the ischioanal fossa. They serve mainly as landmarks: MRI of the canal looks for a mass or scarring near the pudendal nerve. In pelvic venous congestion, venography can show reflux through their connections into vulvar and perineal varices.
Treatment
- Tied or blocked (embolised) to control severe bleeding after birth when other measures fail.
Clinical notes
- Vulvar varicose veins in pregnancy and in pelvic venous congestion often involve pudendal tributaries; those of pregnancy usually shrink after birth
- A needle aimed at the pudendal nerve near the ischial spine can enter these veins, which is why aspiration precedes injection in a pudendal block
- Bleeding from pudendal veins can feed a perineal or vulvar haematoma after birth or trauma
Related conditions
Test yourself
Think of the answer, then tap the question to see it.
What is the course of the internal pudendal veins?
Usually paired companion veins of the internal pudendal artery: pudendal canal, lesser sciatic foramen, ischial spine, greater sciatic foramen, to the internal iliac vein.
How can pelvic venous reflux through the internal pudendal veins appear on the surface?
As vulvar and upper inner thigh varicose veins, via connections with the external pudendal veins.
Why does aspiration precede injection in a pudendal block regarding the internal pudendal vein?
A needle aimed at the pudendal nerve near the ischial spine can enter these veins.
Educational information, not medical advice. For any symptom, see a health professional.
Its names
- Official Latin (TA2)
- vena pudendalis interna TA2 5032
- Official Spanish (DeCS)
- Vena pudenda interna
- English (TA2)
- Internal pudendal vein
- Also called
- vena pudenda interna
Sources: Terminologia Anatomica (TA2); Anatomy, Abdomen and Pelvis: Internal Iliac Arteries; Anatomy, Abdomen and Pelvis, Pudendal Nerve.
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Representative model, for educational purposes only.
