The inferior vesical artery is a blood vessel that supplies the lower part of the urinary bladder, seminal vesicles, and the prostate in males.[5] In females, although this artery is often smaller or absent, its counterpart supplies parts of the bladder and nearby pelvic structures. It arises from the internal iliac artery or sometimes from a branch like the internal pudendal artery or the middle rectal artery.
Location
The inferior vesical artery is located in the pelvis. It originates from the anterior division of the internal iliac artery and travels toward the base of the urinary bladder. In males, it also sends branches to the seminal vesicles and the prostate.[4] The artery runs along the pelvic sidewall before distributing blood to its target structures.
Anatomy
The inferior vesical artery is a key vessel in the pelvic region, primarily responsible for supplying the lower portion of the urinary bladder, prostate, and seminal vesicles in males. In females, the artery is either absent or considerably smaller, contributing to the blood supply of the lower bladder and adjacent pelvic structures. Below is a detailed description of its anatomy.
Origin
The inferior vesical artery typically originates from the anterior division of the internal iliac artery, which is a major arterial source for the pelvic organs. In some cases, the artery may arise from nearby vessels such as the internal pudendal artery or the middle rectal artery. The variability in its origin depends on individual anatomical differences, but it consistently remains a branch of the internal iliac arterial system.
Course
Once the inferior vesical artery branches off from the internal iliac artery, it travels toward the inferior aspect of the urinary bladder.[6] In males, the artery takes a path toward the lower bladder and the prostate gland, crossing through the pelvic fascia and running parallel to the pelvic sidewall. As it approaches the bladder, it divides into smaller branches that supply specific pelvic structures.
Branches
The inferior vesical artery gives rise to several branches that provide blood to nearby structures in the pelvis:
- Bladder Branches: These branches supply the lower portion of the urinary bladder, specifically the base and inferior aspect of the bladder wall.
- Prostatic Branches (Males): In males, the inferior vesical artery sends branches to the prostate gland and seminal vesicles, contributing significantly to the vascular supply of these reproductive structures.
- Ureteral Branches: The artery may also give off small branches to the lower end of the ureter, the tube that connects the kidneys to the bladder.
- Seminal Vesicle Branches (Males): The artery also sends blood to the seminal vesicles, which are located near the base of the bladder and are responsible for contributing fluids to semen.
Relations to Other Structures
The inferior vesical artery runs in close proximity to several key pelvic structures:
- Prostate (Males): In males, it runs adjacent to the prostate gland as it provides blood to this important reproductive organ.
- Seminal Vesicles (Males): The artery supplies the seminal vesicles, which lie near the base of the bladder.
- Bladder: The artery lies near the base of the bladder, ensuring the supply of blood to the inferior portion of the bladder.
- Ureter: In both males and females, the artery may send small branches to the lower part of the ureter.
Variations
There are some anatomical variations in the presence and structure of the inferior vesical artery, especially between males and females:
- Males: The artery is generally well-developed and provides essential blood supply to the prostate, seminal vesicles, and lower bladder.
- Females: In females, the inferior vesical artery is either absent or much smaller. Instead, the vaginal artery or the uterine artery often takes over its role in supplying the bladder and surrounding tissues.[3] The inferior vesical artery, when present, contributes to the blood supply of the bladder but not the reproductive organs.
Anastomoses
The inferior vesical artery forms anastomoses (connections) with other nearby arteries to ensure sufficient blood supply to the pelvic region:
- Superior Vesical Artery: The inferior vesical artery anastomoses with the superior vesical artery, which supplies the upper part of the bladder. This anastomotic connection ensures that the entire bladder is well-perfused.
- Middle Rectal Artery: In some cases, the inferior vesical artery forms anastomoses with the middle rectal artery, which supplies blood to the rectum and lower pelvic structures.
Function
The inferior vesical artery plays a critical role in providing blood to the lower urinary tract and reproductive organs, particularly in males. Below is a detailed explanation of its specific functions.
Blood Supply to the Lower Urinary Bladder
The primary function of the inferior vesical artery is to supply oxygenated blood to the inferior portion of the urinary bladder. The lower part of the bladder, including the base and the bladder neck, relies on this artery for its blood supply. The oxygen and nutrients delivered by the artery are essential for maintaining the health of the bladder tissues, allowing for the storage and timely release of urine.[7] This perfusion helps maintain the integrity and function of the bladder wall, particularly the detrusor muscle, which contracts during urination.
Blood Supply to the Prostate (Males)
In males, the inferior vesical artery provides critical blood supply to the prostate gland, one of the main male reproductive organs. The prostate requires a continuous flow of oxygenated blood to perform its role in producing prostatic fluid, which is a component of semen. The artery branches to form a prostatic vascular network, supporting the gland’s growth and function.
Prostatic Perfusion: This ensures that the prostate remains healthy and capable of carrying out its reproductive functions. Blood flow through the inferior vesical artery supports both the secretory and structural functions of the gland.
Blood Supply to the Seminal Vesicles (Males)
Another essential role of the inferior vesical artery in males is the vascularization of the seminal vesicles. These paired glands, which are located near the base of the bladder, contribute seminal fluid to the ejaculate.[2] The artery supplies the oxygen and nutrients necessary for the proper functioning of the seminal vesicles, helping in the production of seminal fluid, which mixes with sperm to form semen.
Seminal Fluid Production: The blood flow provided by the inferior vesical artery supports the function of the seminal vesicles, which is crucial for male fertility.
Blood Supply to the Ureter
The inferior vesical artery also contributes to the blood supply of the lower part of the ureter, particularly where the ureter enters the bladder. Although the ureter has multiple sources of blood supply from other arteries, the contribution from the inferior vesical artery ensures proper perfusion at the distal part of the ureter, facilitating the passage of urine into the bladder.
Ureteral Health: Adequate blood supply to the lower ureter ensures that its structure and function are maintained, which is important for the smooth flow of urine from the kidneys to the bladder.[8]
Contribution to Pelvic Vascular Network
The inferior vesical artery is part of the pelvic vascular network, which ensures adequate blood supply to various pelvic organs through anastomoses with other arteries. These connections help create a collateral network that guarantees consistent perfusion even if one of the primary arteries is compromised.
- Anastomosis with Superior Vesical Artery: The inferior vesical artery often forms anastomoses with the superior vesical artery, which supplies the upper part of the bladder. This connection ensures that the bladder receives blood from both the superior and inferior sides, contributing to comprehensive vascularization.
- Anastomosis with Middle Rectal Artery: In some cases, the inferior vesical artery connects with the middle rectal artery, supporting the blood supply to both the bladder and rectum. This connection helps maintain the overall health of the pelvic organs.
Supporting Urogenital Health in Females (When Present)
Although the inferior vesical artery is often smaller or absent in females, when present, it supplies blood to the lower part of the bladder and possibly the urethra. The artery, when functioning, contributes to the vascularization of the pelvic structures involved in urinary function.
Bladder Support in Females: The artery, when present, helps supply blood to the base of the bladder, playing a minor role in female urinary tract health.
Support in Healing and Tissue Repair
Like other arteries, the inferior vesical artery plays a crucial role in tissue repair and regeneration. Any injury to the bladder, prostate, or seminal vesicles would rely on the blood supplied by the artery for oxygen, nutrients, and immune cells to promote healing.
Tissue Regeneration: The artery ensures that any damage to the prostate or lower bladder is quickly repaired, maintaining the function of these organs over time.
Clinical Significance
The inferior vesical artery is clinically significant, especially in urology and pelvic surgery, as it supplies blood to the lower urinary bladder, prostate, and seminal vesicles in males. Injury to this artery during surgical procedures, such as prostatectomy (removal of the prostate), bladder surgeries, or during the treatment of pelvic trauma, can result in significant bleeding due to its vascular supply to key pelvic organs.
In males, the artery is also important in the context of prostate cancer surgery or benign prostatic hyperplasia (BPH) treatments, where the blood supply to the prostate must be carefully managed to avoid excessive blood loss.[1] Additionally, during bladder surgeries for tumors or other conditions, preservation or management of the inferior vesical artery ensures adequate blood supply to the bladder for healing and normal function post-surgery.
In embolization procedures, such as in cases of prostatic artery embolization (PAE) for BPH, the inferior vesical artery may need to be carefully considered to prevent complications. Its variable anatomy, particularly in females, also plays a role in pelvic surgeries where the vascular supply needs to be well-understood to prevent unintended damage.
