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Sacral Splanchnic Nerves

nervi splanchnici sacrales

The sacral splanchnic nerves are postganglionic sympathetic fibres arising from the sacral sympathetic ganglia (S2-S4 level sympathetics) and joining the inferior hypogastric plexus. They transmit sympathetic vasoconstrictor and secretomotor impulses to the pelvic viscera, complementing the parasympathetic pelvic splanchnic nerves (nervi erigentes) from S2-S4 ventral rami. They carry visceral pain afferents from the pelvic organs below the peritoneal reflection.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

Sacral splanchnic nerves contribute sympathetic innervation to the bladder detrusor and internal urethral sphincter, the rectum, and the pelvic vascular bed. Along with the pelvic splanchnic nerves, they are disrupted during total mesorectal excision, radical prostatectomy, and radical hysterectomy. Their injury contributes to post-surgical bladder and sexual dysfunction. The distinction between sacral sympathetic supply (sacral splanchnic) and sacral parasympathetic (pelvic splanchnic) is important for understanding the differential effects of pelvic autonomic injuries.

Pathology

Common Injuries & Conditions

Bladder Dysfunction from Sacral Sympathetic Injury

Damage to the sacral splanchnic nerves during pelvic surgery disrupts sympathetic control of the internal urethral sphincter and detrusor, contributing to urinary retention or overflow incontinence that accompanies the more prominent parasympathetic deficit from pelvic splanchnic nerve damage.