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Cadaveric Study of Female Pelvic Nerve Dissection in Phalloplasty: Ilioinguinal and Iliohypogastric Nerves
Diwakar Phuyal MBBS; Daniel Bahat, MD; Filippo Perozzo, MD; William Albabish, MSc, PhD; Dwayne Jackson; Antonio Rampazzo, MD, PhD; Bahar Bassiri Gharb, MD, PhD
Cleveland Clinic
2025-01-16
Presenter: Diwakar Phuyal
Affidavit:
Yes
Director Name: Raymond Isakov
Author Category: Fellow Plastic Surgery
Presentation Category: Basic Science Research
Abstract Category: General Reconstruction
Background:
Tactile and erogenous sensation are vital for protective function and sexual satisfaction after phalloplasty. We aim to provide anatomical analysis of Ilioinguinal (II) and Iliohypogastric (IH) nerve.
Methods:
Ten fresh female cadaver sides were dissected. The II and IH nerves were accessed via groin and midline incisions. Course were recorded relative to the anterior superior iliac spine (ASIS), and the pubic symphysis (PS). Data are presented as median[25th-75th percentile], analyzed using the Mann-Whitney U test.
Results:
The II nerve was 4.0[3.05-4.25] cm lateral to the PS on the right (R) and 3.3[3.15-3.9] cm on the left (L) (p = 0.76), at the level of superior margin of PS. It entered between internal and external obliques piercing the internal oblique muscle 5.3[4.25-5.45] cm inferior and 3.8[3.10-3.90] cm medial to the ASIS (R) vs 5.8[4.5-5.9] cm inferior and 5.10[3.75-5.8] cm medial (L) (p = 0.66 and p = 0.47, respectively). It measured 1.6[1.54-1.6] mm proximally and 1.07[1.04-1.21] mm distally (R) vs 1.3[1.25-1.45] mm proximally and distally (L) (p = 0.81 and p = 0.12, respectively).
The IH nerve was 2.7[1.6-3.7] cm lateral to the PS (R) and 2.8[1.75-3.6] cm (L) (p = 0.56). Additionally, it was 3.75[1.4-6.1] cm (R) and 2.7[1.9-3.9] cm (L) (p = 0.77) superior to the PS and terminated as anterior cutaneous branch.
Conclusion:
The II nerve was located at the level of superior margin and 3-4cm lateral to the PS, while IH nerve was located 2-3cm lateral and 2.54cm superior to the PS underneath external oblique fascia.
