Dr.

DOMNIC MARERA
 Upper Surface

Inferolateral surface Inferolateral surface

Apex

Neck
 URINARY BLADDER
SHAPE:
• It has the shape of three-sided pyramid
placed on one of its angles, with the
apex of pyramid is directed forward &
its base is directed backward
SITE:
• It lies behind the body of pubis & is
separated from it by the retropubic
space
MALE PELVIS
MALE PELVIS
BASE OF MALE BLADDER
FEMALE PELVIS
FEMALE PELVIS
 URINARY BLADDER
RETROPUBIC SPACE:
• It is a space filled with extraperitoneal
fatty tissue continuous with that of
lower part of anterior abdominal wall
• It accomodates distention of urinary
bladder
• In case of rupture of urinary bladder,
urine may escape upward into the
anterior abdominal wall
 URINARY BLADDER
APEX:
• Is directed forward
• Is related to upper border of symphysis
pubis
• Is connected to umbilicus by the
median umbilical ligament (obliterated
part of urachus)
 URINARY BLADDER
BASE (POSTERIOR SURFACE):
• Is directed backward
• Its superolateral angles receive the ureters
• In male:
1. Its upper part is covered by peritoneum
2. It is related to vasa deferentia & seminal
vesicles separating it from rectum
• In female:
1. It has no peritoneal covering
2. It is related to vagina
 URINARY BLADDER
SUPERIOR SURFACE:
• Is covered by peritoneum in both sexes
• In male: it is related to sigmoid colon &
loops of ileum
• In female: it is related to the uterus
separating it from sigmoid colon &
loops of ileum
 URINARY BLADDER
INFEROLATERAL SURFACES:
• Are related to retropubic fat
separating them from:
1. Body of pubis
2. Levator ani
3. Obturator internus
 URINARY BLADDER
NECK:
• Is the lowest & most fixed part
• Lies behind symphysis pubis
• Is continuous with urethra
• In male:
1. It rests on upper surface of prostate
2. Anteriorly: it is attached to puboprostatic ligament
3. Posteriorly: it is related to beginning of ejaculatory
ducts
• In female:
1. Anteriorly: it is attached to pubovesical ligament
2. Posteriorly: it is related to anterior wall of vagina
 URINARY BLADDER
LIGAMENTS:
1. Median umbilical ligament
2. Puboprostatic (pubovesical) ligament:
• Forms the floor of retropubic space
• In male: is called “puboprostatic” &
extends from body of pubis to
prostatic fascia & neck of bladder
• In female: is called “pubovesical” &
extends from body of pubis to neck of
bladder
INTERIOR OF URINARY BLADDER
 INTERIOR OF URINARY BLADDER
• The mucous membrane forms folds (rugae)
that disappear when the bladder is distended
• TRIGONE:
1. A triangular area in the base of bladder,
bounded by the 2 ureteric orifices & the
internal urethral orifice
2. Its mucous membrane is elastic, more
vascular & more sensitive
• UVULA VESICA: is an elevation immediately
behind internal urethral orifice produced by
the underlying median lobe of prostate
 URINARY BLADDER

Distended Empty
 URINARY BLADDER
CAPACITY:
• Is about 300 ml with a maximum
capacity of 500 ml
• Distended bladder:
• Is circular in shape
• Bulges upward into abdominal cavity
• Removes peritoneum form lower part
of anterior abdominal wall & becomes
into direct contact with it
URINARY BLADDER IN CHILD
• It is an abdominal
organ even when
empty
• It begins to enter the
enlarging pelvis at
six years of age
• It is not entirely a
pelvic organ till after
puberty
Median sagittal section of
a new-born female child
 URINARY BLADDER
ARTERIAL SUPPLY:
• Superior & inferior vesical arteries
VENOUS DRAINAGE:
• Veins from the vesical venous plexus
that drain into the internal iliac vein
LYMPHATIC DRAINAGE:
• Into internal & external iliac lymph
nodes
 URINARY BLADDER
• NERVE SUPPLY: by the inferior
hypogastric plexuses
1. Parasympathetic fibers: from S2,3,4 motor
to detrusor muscle (muscle coat of
bladder) & inhibitory to internal urethral
sphincter, produce micturation
2. Sympathetic fibers: from first & second
lumbar ganglia
3. Ascending sensory fibers: carry sensation
of fullness (distention) & pain sensation
 PELVIC PART OF URETER
• Crosses the front of
bifurcation of common
iliac artery to reach the
pelvis
• Descends downward &
backward, along the lower
border of internal iliac
artery, crossing (from
above downward):
1. External iliac artery & vein
2. Obturator nerve, artery &
vein
• Curves forward & medially
 IN MALE
• It is crossed
anteriorly by
vas deferens
 IN FEMALE
• It passes below
the root of
broad ligament
lateral to lateral
fornix of vagina
& is crossed
superiorly by
the uterine
artery
 PELVIC PART OF URETER
TERMINATION:
• It reaches the posterosuperior angle of
bladder
• It runs an oblique course of about 2 cm
through the wall of bladder before it
opens into its lumen (intramural part of
ureter). This part forms a valve-like
mechanism that prevents reflux of urine
into the ureter when bladder is distended
INTRAVENOUS UROGRAM
INTRAVENOUS UROGRAM