Uterovaginal plexus (nerves)

The uterovaginal plexus is a network of autonomic nerves located in the parametrium, adjacent to the uterus and vagina. It is a major component of the pelvic autonomic nervous system and plays a crucial role in controlling various functions of the female reproductive system, including uterine contractions, blood flow to the uterus and vagina, and glandular secretions.

The plexus receives contributions from both the sympathetic and parasympathetic nervous systems. Sympathetic fibers originate primarily from the inferior hypogastric plexus and contribute to vasoconstriction. Parasympathetic fibers, derived from the pelvic splanchnic nerves (S2-S4), are responsible for vasodilation and stimulation of glandular secretions. The precise interplay between these two divisions is complex and still under investigation.

The uterovaginal plexus is intimately associated with the uterine artery and vein. It accompanies these vessels as they traverse the parametrium to reach the uterus.

Damage to the uterovaginal plexus can occur during pelvic surgery, such as hysterectomy, and may result in various complications, including urinary dysfunction (although the vesical plexus is more directly involved in bladder control), sexual dysfunction (including decreased vaginal lubrication and altered sensation), and bowel dysfunction. Preservation of these nerves during surgery is therefore an important consideration in order to minimize postoperative morbidity. The plexus also plays a role in the transmission of pain signals from the uterus and vagina.

It is also known as the Frankenhäuser ganglion, although this term technically refers to the larger inferior hypogastric plexus from which the uterovaginal plexus originates.