Anatomical bases of external pudendal artery injuries during surgical treatment of pelvic limb varices

Introduction: External pudendal artery is a collateral branch of the common femoral artery which is the primary blood supply to the penis or the clitoris. Its relationship with the venous arch of the great saphenous vein and its afferents in femoral triangle, are very narrow. This often entails injuries during crossectomy and great saphenous vein stripping. These lesions can cause sexual dysfunction. Methods: This study reports the case of a dissection of 22 inguinal regions in 13 men and 9 women who underwent surgical treatment of the femoral triangle. The distribution and the relationship between the external pudendal artery and the venous arch of the great saphenous vein are studied. Results: Single external pudendal artery is the most common. All external pudendal arteries originate from the common femoral artery. The most common type of relationship is between the sub-crossing of the venous arch of the great saphenous vein and a single external pudendal artery. Moreover, we recorded a precrossing, an alternate crossing and some relationship with the common femoral vein and the afferences of the venous arch of the great saphenous vein. Some surgical techniques expose more or less to external pudendal artery injury. Conclusion: This study confirms previous data but shows some peculiarities about the relationship between the venous arch of the great saphenous vein and external pudendal artery.