Home › Body Atlas › Vessels › Middle Rectal Artery

Middle Rectal Artery

arteria rectalis media

The middle rectal artery is the critical collateral supply to the rectum after superior rectal artery ligation in rectal cancer surgery. Its adequacy determines the safety of the colorectal anastomosis. The middle rectal artery also supplies the prostate, seminal vesicles, and vagina in the lateral pelvic sidewall — autonomic nerve preservation requires staying medial to this vessel during radical prostatectomy and rectal resection.

Region: Pelvis & Hip

Anatomical Data

Origin, Insertion & Supply

Origin	Anterior trunk of the internal iliac artery

Clinical Relevance

Clinical Notes

During total mesorectal excision (TME) for rectal cancer, the autonomic nerves (hypogastric plexus and pelvic splanchnic nerves) must be preserved medial to the middle rectal vessels to maintain bladder and sexual function. Nerve-sparing TME reduces post-operative urinary retention and erectile dysfunction rates from >50% to less than 20%.

Pathology

Common Injuries & Conditions

Nerve Injury at Middle Rectal Artery Level

Autonomic nerve damage during lateral dissection near the middle rectal artery producing post-operative urinary retention and erectile dysfunction — prevented by nerve-sparing TME technique.