The pudendal nerve arises from the second, third, and fourth sacral nerves. It passes out of the pelvis through the greater sciatic foramen, below the pyriformis muscle, accompanies the internal pudendal vessels across the spine of the ischium. It reenters the pelvis through the lesser sciatic foramen. It is sheathed by the obturator fascia, passes forward in the lateral wall of the ischiorectal fossa, and divides into the perineal and dorsalis penis nerves. The pudendal nerve, as it passes through the lesser sciatic foramen, usually gives off the inferior hemorrhoidal nerve which is accompanied by the inferior hemorrhoidal vessels. It crosses the ischiorectal fossa to the lower end of the rectum, where it supplies muscular branches to the external sphincter ani, cutaneous filaments to the perianal integument, and communicating branches to the inferior pudendal and superficial perineal nerves.

Nervus pudendus

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