In this note, we will consider the anatomy, areas of blood drainage and anastomoses of the internal iliac vein.

The internal iliac vein (v. iliaca interna) lies on the lateral wall of the pelvis behind the artery of the same name. It arises above the greater sciatic notch by the confluence of numerous pelvic veins.

It flows into the common iliac vein (v. iliaca communis).

This vein drains blood from the pelvic organs and pelvic wall, perineum and external genitalia, gluteal region, and medial femoral area.

The tributaries of the internal iliac vein can be divided into two groups:

1. Parietal tributaries

2. Visceral tributaries

Parietal tributaries carry blood from the walls of the pelvic cavity and include:

1. The superior gluteal vein (v. gluteus superior)

   

2. The inferior gluteal vein (v. gluteus inferior)

   

3. Obturator veins (vv. obturatoriae)

   

4. Lateral sacral veins (vv. sacrales laterales)

   

5. The iliolumbar vein (v. iliolumbalis)

Visceral tributaries carry blood from the pelvic organs and these include:

1. The sacral venous plexus (plexus venosus sacralis)

   

2. The prostatic venous plexus (plexus venosus prostaticus)

3. Uterine veins (vv. uterinae)

   

4. Vesical veins (vv. vesicales)

   

   

5. The internal pedundal vein (v. pudenda interna)

   

   

6. Middle rectal veins (vv. rectales mediae)

Let’s consider the tributaries in greater detail.

The superior gluteal vein (v. gluteus superior) passes posteriorly between the lumbosacral trunk of the sacral plexus and the first sacral spinal nerve. Then it leaves the pelvis through the greater sciatic foramen above the piriformis muscle.

It drains blood from the piriformis muscle, obturator internus muscle, ileum, gluteus maximus, gluteus medius, gluteus minor, skin over the sacrum, hip joint, tensor of the fascia lata of the thigh.

The inferior gluteal vein (v. gluteus inferior) drains blood from the piriformis, coccygeus, iliococcygeus, gluteus maximus muscles, as well as from the obturator internus muscle, superior and inferior gemullus muscles, and quadratus femoris muscle. Small veins from the sciatic nerve, as well as the skin of the gluteal and femoral areas end by it.

Obturator veins (vv. obturatoriae)

Lateral sacral veins (vv. sacrales laterales)

The iliolumbar vein (v. iliolumbalis).

The last three veins are the venae comitans to the arteries of the same name. These veins have valves.

The sacral venous plexus (plexus venosus sacralis) is formed by the anastomoses of the roots of the sacral lateral and median veins.

The prostatic venous plexus (plexus venosus prostaticus) is a thick plexus of major veins surrounding the prostate gland and seminal vesicles. The following veins end by this plexus:

the deep dorsal vein of the penis (v. dorsalis profunda penis);

deep veins of the penis (vv. profundae penis); posterior scrotal veins (vv. scrotales posteriores), which penetrate into the pelvic cavity through the genitourinary diaphragm.

The vaginal venous plexus (plexus venosus vaginalis) surrounds the urethra and vagina. In the superior part, it passes into the uterine venous plexus (plexus venosus uterinus) surrounding the cervix.

The blood drainage from these plexuses occurs throug he uterine veins (vv. uterinae).

The urinary venous plexus (plexus venosus vesicalis) covers the urinary bladder from the flanks and in the bottom area.

Blood from this plexus drains through the vesical veins (vv. vesicales).

The rectal venous plexus (plexus venosus rectalis) adheres to the rectum from behind and from the flanks, and also branches in its submucosa. It has the most complex structure in the inferior part of the rectum.

From this plexus, blood drains through one unpaired and two paired middle and inferior rectal veins, which anastomose with each other in the walls of the rectum.

The superior rectal vein (v. rectalis superior) ends by the inferior mesenteric vein.

The middle rectal veins (vv. rectales mediae) are paired, they drain blood from the middle part of the rectum and end by the internal iliac vein.

The lower rectal veins (vv. rectales inferiores) are paired, blood drains through them into the internal pedundal vein (v. pudenda interna) (tributary of the internal iliac vein).

Dictionary

The internal iliac vein

Internal iliac vein

v. iliaca interna

Common iliac vein

v. iliaca communis

Obturator veins

vv. obturatoriae

Lateral sacral veins

vv. sacrales laterales

Iliolumbar vein

v. iliolumbalis

Sacral venous plexus

plexus venosus sacralis

Prostatic venous plexus

plexus venosus prostaticus

Deep dorsal vein of thepenis

v. dorsalis profundapenis

Deep veins of the penis

vv. profundae penis

Posterior scrotal veins

vv. scrotales posteriores

Vaginal venous plexus

plexus venosus vaginalis

Uterine venous plexus

plexus venosus uterinus

Uterine veins

vv. uterinae

Vesical venous plexus

plexus venosus vesicalis

Vesical veins

vv. vesicales

Rectal venous plexus

plexus venosus rectalis

Superior rectal vein

v. rectalis superior

Middle rectal veins

vv. rectales mediae

Inferior rectal veins

vv. rectales inferiores

Internal pudendal vein

v. pudenda interna

Superior gluteal veins

v. gluteus superior

Inferior gluteal veins

v. gluteus inferior