Vol. 3, Issue 6 (2017)
A study of superficial external Pudendal artery and its variations at Saphenofemoral junction
Author(s): Dr. Kshitij Manerikar, Dr. Digvijay Jadhav, Dr. Simran Bhatia, Dr. Gurjit Singh, Dr. Vashisht Dikshit
Abstract: Introduction: Knowledge of anatomical location of Superficial External Pudendal Artery (SEPA), its origin and course is very important while exploring SFJ and ligating its various branches. Surgeon can face dilemma while identifying SEPA, as it lies close to femoral artery and femoral vein. Operating surgeon should know about variations in SEPA, such as its origin, absence and also duplication or rarely even triple pudendal arteries. Materials and Methods: A prospective non-randomized study of consecutive fifty patients with primary varicose veins who underwent Trendelenburg procedure was carried out. All patients underwent Trendelenburg’s operation with stripping of great saphenous vein (GSV).The SEPA was identified by its pulsation. The origin of SEPA, its number and position weather, anterior or posterior to SFJ or medial or lateral to femoral artery were recorded diligently. Results: In our study of fifty patients, 36 were male and 14 were female. Meticulous search for SEPA by careful dissection was done during all surgical exploration. Origin of SEPA and its relation to SFJ was recorded. We noticed that SEPA was not visualized in two (4%) patients whereas, it was identifiable in rest 48 (96%) patients. We found that SEPA was originating from medial side of femoral artery and it was piercing fascia of thigh and was further passing superio-medially towards the pubis symphysis. Superficial external pudendal artery was crossing anterior to SFJ in 20 (40%) patients whereas it was crossing posterior to SFJ in 28 (56%) patients. Conclusion: Our study showed that meticulous search and careful dissection can identify superficial external pudendal artery. SEPA was crossing posterior to SFJ in our maximum cases. One must ligate SEPA as soon as encountered while dissection. This will avoid inadvertent injury to SEPA causing torrential bleeding and further increasing post-operative complications.