![\"\"](\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/urinary_system-1.png\")
<\/a>Urinary bladder<\/h3>\n<\/span>\n\n\nThe urinary bladder is a hollow muscular sac that holds urine.<\/p>\n\n\n<\/span>\nLocation<\/h4>\n<\/span>\n\n\nThe urinary bladder is located in the lower pelvis and is infraperitoneal (under the peritoneum), posterior to the pubic symphysis.<\/p>\n\n\n\n
- The urinary bladder lies on the\u00a0pubic bones, fascia of the levator ani and superior part of obturator internus.<\/li>
- Between the pubic symphysis and bladder there’s a potential space known as the retropubic space (or cave of Retzius).<\/li>
- In children and infants, the bladder is in the abdomen even when empty.<\/li><\/ul>\n\n\n\n
![\"\"](\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/urinary-bladder-in-men-and-women-600x282.png\")
<\/a>Figure 2. Male and female urinary bladder<\/strong>\u00a0(Credit: Tsaitgaist,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nParts<\/h4>\n<\/span>\n\n\nThe bladder consists of 3 parts:<\/p>\n\n\n\n
- Fundus<\/strong> \u2014 The superior part<\/li>
- Base<\/strong> \u2014 The inferior part<\/li>
- Apex<\/strong> \u2014 The anterior part<\/li><\/ol>\n\n\n\n
![\"\"](\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/bladder-anatomy-parts-600x282.png\")
<\/a>Figure 3. Parts of the bladder<\/strong>\u00a0(Credit: Tsaitgaist,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nInternal anatomy<\/h4>\n<\/span>\n\n\nWhen collapsed, the internal surface of the bladder has numerous folds often called rugae<\/strong>, as with the stomach \u2014 allowing great expansion.<\/p>\n\n\n\nThe base of the bladder has a triangular surface formed by the paired urethral openings<\/strong> which convey urine from the kidneys through the ureters and the urethral opening<\/strong>, allowing urine to be passed during urination \u2014 this triangular region can be seen even in cadavers; compared to the rest of the bladder it is smooth, thanks to the lack of submucosa within its lining (the rest of the bladder wall has submucosa).<\/p>\n\n\n\n![\"\"](\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/internal-anatomy-of-the-bladder-600x368.png\")
<\/a>Figure 3. Internal anatomy of the bladder<\/strong>\u00a0(Credit: OpenStax,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nLigaments and connective tissue<\/h4>\n<\/span>\n\n\nThe bladder is surrounded by numerous ligaments, connective, and adipose tissue.<\/p>\n\n\n\n
- True ligaments<\/strong>\u00a0\u2014 Formed by the thickening of pelvic fascia:
- Lateral ligaments of the bladder<\/strong><\/li>
- Posterior ligaments of the bladder<\/strong><\/li>
- Puboprostatic ligament\u00a0<\/strong>in males<\/li>
- Pubovesical<\/strong>\u00a0and\u00a0vesicocervical\u00a0ligaments\u00a0<\/strong>in females<\/li>
- Median umbilical ligament<\/strong><\/li><\/ul><\/li>
- False ligaments\u00a0<\/strong>\u2014 Formed by reflections of peritoneum and have little to no function in holding the urinary bladder in place:
- Lateral reflections of peritoneum forming the paravesical fossae to the sides of the bladder<\/li>
- Posterior reflections of peritoneum forming the rectouterine (females) and vesicorectal (males) pouch<\/li>
- The median and medial umbilical folds<\/li><\/ul><\/li>
- Paracystium\u00a0<\/strong>describes the soft connective tissue and adipose tissue surrounding the bladder. It is found laterally, and transversed by the vesical venous plexus (see below).<\/li><\/ul>\n\n\n\n
![\"\"](\"https:\/\/meddists.com\/wp-content\/uploads\/2018\/08\/bladder-uterus-ligaments-600x392.png\")
<\/a>Figure 4. A cross-section showing the ligaments of the bladder and uterus<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Branches of the\u00a0internal iliac artery<\/strong>:
Superior vesicle artery<\/strong>
Inferior vesicle artery<\/strong>\u00a0in men,\u00a0vaginal artery<\/strong>\u00a0in females
Small branches coming from other nearby arteries (obturator\/inferior gluteal arteries) <\/td><\/tr>Venous drainage<\/strong><\/td>Vesical venous plexus<\/strong><\/strong>, drains into the internal iliac veins<\/td><\/tr>Innervation<\/strong><\/td>Intermesenteric plexus<\/strong>, from the greater, lesser, and least splanchnic (sympathetic), and vagus (parasympathetic).<\/td><\/tr>Lymphatic drainage<\/strong><\/td>Common and internal iliac lymph nodes <\/td><\/tr><\/tbody><\/table>Table 1. Neurovasculature of the bladder<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nUrethra<\/h3>\n<\/span>\n\n<\/span>\nDescription<\/h4>\n<\/span>\n\n\nThe urethra is a muscular tube that conveys urine out of the body. In males, it also conveys the products of ejaculation.<\/p>\n\n\n\n
The urethra starts at the internal urethral orifice at the apex of the bladder and ends as the external urethral orifice at the tip of the penis in males, and deep to the labia minora in females.<\/p>\n\n\n<\/span>\nCourse<\/h4>\n<\/span>\n\n\n- In males, the urethra is much longer than that of a female. It passes through the prostate, deep perineal pouch, and perineal membrane, before forming an angle as it enters the corpus spongiosum of the penis.
- In an erect penis, the penile urethra is straight, while in an unerect penis there\u2019s an additional angle formed by the resting penis.<\/li><\/ul><\/li>
- In females, the urethra is short (4cm) and passes parallel to the vagina directly to its opening between the labia minora anterior to the vaginal vestibule, without forming any angles.<\/li><\/ul>\n\n\n<\/span>\n
Parts<\/h4>\n<\/span>\n\n\nThe male urethra can be divided into 4 parts:<\/p>\n\n\n\n
- Preprostatic urethra<\/li>
- Prostatic urethra<\/li>
- Membranous urethra<\/li>
- Penile (spongy) urethra<\/li><\/ol>\n\n\n\n
In females, the urethra is generally not divided.<\/p>\n\n\n<\/span>\nSphincters<\/h4>\n<\/span>\n\n\n- In males, the internal urethral orifice is surrounded by a smooth muscle that acts as a sphincter (the internal urethral sphincter<\/strong>); this sphincter is absent in females.
- The role of the sphincter is to prevent the passage of urine during intercourse.<\/li><\/ul><\/li>
- The external urethral sphincter <\/strong>is a skeletal muscle found deep to the perineal membrane that allows voluntary control over the voiding process.
<\/li><\/ul>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Urethral artery<\/strong> (branch of the internal pudendal artery)
Prostatic plexus, bulbar and dorsal arteries of the penis<\/strong> (males)
Vaginal artery<\/strong> (females) <\/td><\/tr>Venous drainage<\/strong><\/td>Urethral vein <\/strong>(draining into the internal pudendal vein)
Prostatic venous plexus <\/strong>(males)
Vaginal venous plexus <\/strong>(females) <\/td><\/tr>Innervation<\/strong><\/td>The prostatic urethra is innervated by the prostatic plexus<\/strong>, arising from the inferior hypogastric plexus<\/strong>
The rest of the urethra is innervated by the vesical plexus<\/strong> and the pudendal nerve<\/strong> <\/td><\/tr>Lymphatic drainage<\/strong><\/td> Internal iliac and deep inguinal nodes<\/td><\/tr><\/tbody><\/table>Table 2. Neurovasculature of the urethra<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nGallery<\/h4>\n<\/span>\n\n\n![\"\"\/](\"https:\/\/meddists.com\/wp-content\/uploads\/2020\/02\/female-150x150.png\")
<\/a>Female urogenital system (Credit: Bioscope, HUG, DIP and Odile Fillod, CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n\n![\"\"\/](\"https:\/\/meddists.com\/wp-content\/uploads\/2020\/02\/male-150x150.png\")
<\/a>Male urogenital system (Credit: Bioscope, HUG, DIP and Odile<\/figcaption><\/figure>\n<\/span>
Location<\/h4>\n<\/span>\n\n\nThe urinary bladder is located in the lower pelvis and is infraperitoneal (under the peritoneum), posterior to the pubic symphysis.<\/p>\n\n\n\n
- The urinary bladder lies on the\u00a0pubic bones, fascia of the levator ani and superior part of obturator internus.<\/li>
- Between the pubic symphysis and bladder there’s a potential space known as the retropubic space (or cave of Retzius).<\/li>
- In children and infants, the bladder is in the abdomen even when empty.<\/li><\/ul>\n\n\n\n<\/a>
Figure 2. Male and female urinary bladder<\/strong>\u00a0(Credit: Tsaitgaist,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nParts<\/h4>\n<\/span>\n\n\nThe bladder consists of 3 parts:<\/p>\n\n\n\n
- Fundus<\/strong> \u2014 The superior part<\/li>
- Base<\/strong> \u2014 The inferior part<\/li>
- Apex<\/strong> \u2014 The anterior part<\/li><\/ol>\n\n\n\n<\/a>
Figure 3. Parts of the bladder<\/strong>\u00a0(Credit: Tsaitgaist,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nInternal anatomy<\/h4>\n<\/span>\n\n\nWhen collapsed, the internal surface of the bladder has numerous folds often called rugae<\/strong>, as with the stomach \u2014 allowing great expansion.<\/p>\n\n\n\nThe base of the bladder has a triangular surface formed by the paired urethral openings<\/strong> which convey urine from the kidneys through the ureters and the urethral opening<\/strong>, allowing urine to be passed during urination \u2014 this triangular region can be seen even in cadavers; compared to the rest of the bladder it is smooth, thanks to the lack of submucosa within its lining (the rest of the bladder wall has submucosa).<\/p>\n\n\n\n<\/a>Figure 3. Internal anatomy of the bladder<\/strong>\u00a0(Credit: OpenStax,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nLigaments and connective tissue<\/h4>\n<\/span>\n\n\nThe bladder is surrounded by numerous ligaments, connective, and adipose tissue.<\/p>\n\n\n\n
- True ligaments<\/strong>\u00a0\u2014 Formed by the thickening of pelvic fascia:
- Lateral ligaments of the bladder<\/strong><\/li>
- Posterior ligaments of the bladder<\/strong><\/li>
- Puboprostatic ligament\u00a0<\/strong>in males<\/li>
- Pubovesical<\/strong>\u00a0and\u00a0vesicocervical\u00a0ligaments\u00a0<\/strong>in females<\/li>
- Median umbilical ligament<\/strong><\/li><\/ul><\/li>
- False ligaments\u00a0<\/strong>\u2014 Formed by reflections of peritoneum and have little to no function in holding the urinary bladder in place:
- Lateral reflections of peritoneum forming the paravesical fossae to the sides of the bladder<\/li>
- Posterior reflections of peritoneum forming the rectouterine (females) and vesicorectal (males) pouch<\/li>
- The median and medial umbilical folds<\/li><\/ul><\/li>
- Paracystium\u00a0<\/strong>describes the soft connective tissue and adipose tissue surrounding the bladder. It is found laterally, and transversed by the vesical venous plexus (see below).<\/li><\/ul>\n\n\n\n<\/a>
Figure 4. A cross-section showing the ligaments of the bladder and uterus<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Branches of the\u00a0internal iliac artery<\/strong>:
Superior vesicle artery<\/strong>
Inferior vesicle artery<\/strong>\u00a0in men,\u00a0vaginal artery<\/strong>\u00a0in females
Small branches coming from other nearby arteries (obturator\/inferior gluteal arteries) <\/td><\/tr>Venous drainage<\/strong><\/td>Vesical venous plexus<\/strong><\/strong>, drains into the internal iliac veins<\/td><\/tr>Innervation<\/strong><\/td>Intermesenteric plexus<\/strong>, from the greater, lesser, and least splanchnic (sympathetic), and vagus (parasympathetic).<\/td><\/tr>Lymphatic drainage<\/strong><\/td>Common and internal iliac lymph nodes <\/td><\/tr><\/tbody><\/table>Table 1. Neurovasculature of the bladder<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nUrethra<\/h3>\n<\/span>\n\n<\/span>\nDescription<\/h4>\n<\/span>\n\n\nThe urethra is a muscular tube that conveys urine out of the body. In males, it also conveys the products of ejaculation.<\/p>\n\n\n\n
The urethra starts at the internal urethral orifice at the apex of the bladder and ends as the external urethral orifice at the tip of the penis in males, and deep to the labia minora in females.<\/p>\n\n\n<\/span>\nCourse<\/h4>\n<\/span>\n\n\n- In males, the urethra is much longer than that of a female. It passes through the prostate, deep perineal pouch, and perineal membrane, before forming an angle as it enters the corpus spongiosum of the penis.
- In an erect penis, the penile urethra is straight, while in an unerect penis there\u2019s an additional angle formed by the resting penis.<\/li><\/ul><\/li>
- In females, the urethra is short (4cm) and passes parallel to the vagina directly to its opening between the labia minora anterior to the vaginal vestibule, without forming any angles.<\/li><\/ul>\n\n\n<\/span>\n
Parts<\/h4>\n<\/span>\n\n\nThe male urethra can be divided into 4 parts:<\/p>\n\n\n\n
- Preprostatic urethra<\/li>
- Prostatic urethra<\/li>
- Membranous urethra<\/li>
- Penile (spongy) urethra<\/li><\/ol>\n\n\n\n
In females, the urethra is generally not divided.<\/p>\n\n\n<\/span>\nSphincters<\/h4>\n<\/span>\n\n\n- In males, the internal urethral orifice is surrounded by a smooth muscle that acts as a sphincter (the internal urethral sphincter<\/strong>); this sphincter is absent in females.
- The role of the sphincter is to prevent the passage of urine during intercourse.<\/li><\/ul><\/li>
- The external urethral sphincter <\/strong>is a skeletal muscle found deep to the perineal membrane that allows voluntary control over the voiding process.
<\/li><\/ul>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Urethral artery<\/strong> (branch of the internal pudendal artery)
Prostatic plexus, bulbar and dorsal arteries of the penis<\/strong> (males)
Vaginal artery<\/strong> (females) <\/td><\/tr>Venous drainage<\/strong><\/td>Urethral vein <\/strong>(draining into the internal pudendal vein)
Prostatic venous plexus <\/strong>(males)
Vaginal venous plexus <\/strong>(females) <\/td><\/tr>Innervation<\/strong><\/td>The prostatic urethra is innervated by the prostatic plexus<\/strong>, arising from the inferior hypogastric plexus<\/strong>
The rest of the urethra is innervated by the vesical plexus<\/strong> and the pudendal nerve<\/strong> <\/td><\/tr>Lymphatic drainage<\/strong><\/td> Internal iliac and deep inguinal nodes<\/td><\/tr><\/tbody><\/table>Table 2. Neurovasculature of the urethra<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nGallery<\/h4>\n<\/span>\n\n\n<\/a>Female urogenital system (Credit: Bioscope, HUG, DIP and Odile Fillod, CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n\n<\/a>Male urogenital system (Credit: Bioscope, HUG, DIP and Odile<\/figcaption><\/figure>\n<\/span>
<\/a>Parts<\/h4>\n<\/span>\n\n\nThe bladder consists of 3 parts:<\/p>\n\n\n\n
- Fundus<\/strong> \u2014 The superior part<\/li>
- Base<\/strong> \u2014 The inferior part<\/li>
- Apex<\/strong> \u2014 The anterior part<\/li><\/ol>\n\n\n\n<\/a>
Figure 3. Parts of the bladder<\/strong>\u00a0(Credit: Tsaitgaist,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nInternal anatomy<\/h4>\n<\/span>\n\n\nWhen collapsed, the internal surface of the bladder has numerous folds often called rugae<\/strong>, as with the stomach \u2014 allowing great expansion.<\/p>\n\n\n\nThe base of the bladder has a triangular surface formed by the paired urethral openings<\/strong> which convey urine from the kidneys through the ureters and the urethral opening<\/strong>, allowing urine to be passed during urination \u2014 this triangular region can be seen even in cadavers; compared to the rest of the bladder it is smooth, thanks to the lack of submucosa within its lining (the rest of the bladder wall has submucosa).<\/p>\n\n\n\n<\/a>Figure 3. Internal anatomy of the bladder<\/strong>\u00a0(Credit: OpenStax,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nLigaments and connective tissue<\/h4>\n<\/span>\n\n\nThe bladder is surrounded by numerous ligaments, connective, and adipose tissue.<\/p>\n\n\n\n
- True ligaments<\/strong>\u00a0\u2014 Formed by the thickening of pelvic fascia:
- Lateral ligaments of the bladder<\/strong><\/li>
- Posterior ligaments of the bladder<\/strong><\/li>
- Puboprostatic ligament\u00a0<\/strong>in males<\/li>
- Pubovesical<\/strong>\u00a0and\u00a0vesicocervical\u00a0ligaments\u00a0<\/strong>in females<\/li>
- Median umbilical ligament<\/strong><\/li><\/ul><\/li>
- False ligaments\u00a0<\/strong>\u2014 Formed by reflections of peritoneum and have little to no function in holding the urinary bladder in place:
- Lateral reflections of peritoneum forming the paravesical fossae to the sides of the bladder<\/li>
- Posterior reflections of peritoneum forming the rectouterine (females) and vesicorectal (males) pouch<\/li>
- The median and medial umbilical folds<\/li><\/ul><\/li>
- Paracystium\u00a0<\/strong>describes the soft connective tissue and adipose tissue surrounding the bladder. It is found laterally, and transversed by the vesical venous plexus (see below).<\/li><\/ul>\n\n\n\n<\/a>
Figure 4. A cross-section showing the ligaments of the bladder and uterus<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Branches of the\u00a0internal iliac artery<\/strong>:
Superior vesicle artery<\/strong>
Inferior vesicle artery<\/strong>\u00a0in men,\u00a0vaginal artery<\/strong>\u00a0in females
Small branches coming from other nearby arteries (obturator\/inferior gluteal arteries) <\/td><\/tr>Venous drainage<\/strong><\/td>Vesical venous plexus<\/strong><\/strong>, drains into the internal iliac veins<\/td><\/tr>Innervation<\/strong><\/td>Intermesenteric plexus<\/strong>, from the greater, lesser, and least splanchnic (sympathetic), and vagus (parasympathetic).<\/td><\/tr>Lymphatic drainage<\/strong><\/td>Common and internal iliac lymph nodes <\/td><\/tr><\/tbody><\/table>Table 1. Neurovasculature of the bladder<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nUrethra<\/h3>\n<\/span>\n\n<\/span>\nDescription<\/h4>\n<\/span>\n\n\nThe urethra is a muscular tube that conveys urine out of the body. In males, it also conveys the products of ejaculation.<\/p>\n\n\n\n
The urethra starts at the internal urethral orifice at the apex of the bladder and ends as the external urethral orifice at the tip of the penis in males, and deep to the labia minora in females.<\/p>\n\n\n<\/span>\nCourse<\/h4>\n<\/span>\n\n\n- In males, the urethra is much longer than that of a female. It passes through the prostate, deep perineal pouch, and perineal membrane, before forming an angle as it enters the corpus spongiosum of the penis.
- In an erect penis, the penile urethra is straight, while in an unerect penis there\u2019s an additional angle formed by the resting penis.<\/li><\/ul><\/li>
- In females, the urethra is short (4cm) and passes parallel to the vagina directly to its opening between the labia minora anterior to the vaginal vestibule, without forming any angles.<\/li><\/ul>\n\n\n<\/span>\n
Parts<\/h4>\n<\/span>\n\n\nThe male urethra can be divided into 4 parts:<\/p>\n\n\n\n
- Preprostatic urethra<\/li>
- Prostatic urethra<\/li>
- Membranous urethra<\/li>
- Penile (spongy) urethra<\/li><\/ol>\n\n\n\n
In females, the urethra is generally not divided.<\/p>\n\n\n<\/span>\nSphincters<\/h4>\n<\/span>\n\n\n- In males, the internal urethral orifice is surrounded by a smooth muscle that acts as a sphincter (the internal urethral sphincter<\/strong>); this sphincter is absent in females.
- The role of the sphincter is to prevent the passage of urine during intercourse.<\/li><\/ul><\/li>
- The external urethral sphincter <\/strong>is a skeletal muscle found deep to the perineal membrane that allows voluntary control over the voiding process.
<\/li><\/ul>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Urethral artery<\/strong> (branch of the internal pudendal artery)
Prostatic plexus, bulbar and dorsal arteries of the penis<\/strong> (males)
Vaginal artery<\/strong> (females) <\/td><\/tr>Venous drainage<\/strong><\/td>Urethral vein <\/strong>(draining into the internal pudendal vein)
Prostatic venous plexus <\/strong>(males)
Vaginal venous plexus <\/strong>(females) <\/td><\/tr>Innervation<\/strong><\/td>The prostatic urethra is innervated by the prostatic plexus<\/strong>, arising from the inferior hypogastric plexus<\/strong>
The rest of the urethra is innervated by the vesical plexus<\/strong> and the pudendal nerve<\/strong> <\/td><\/tr>Lymphatic drainage<\/strong><\/td> Internal iliac and deep inguinal nodes<\/td><\/tr><\/tbody><\/table>Table 2. Neurovasculature of the urethra<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nGallery<\/h4>\n<\/span>\n\n\n<\/a>Female urogenital system (Credit: Bioscope, HUG, DIP and Odile Fillod, CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n\n<\/a>Male urogenital system (Credit: Bioscope, HUG, DIP and Odile<\/figcaption><\/figure>\n<\/span>
<\/a>Internal anatomy<\/h4>\n<\/span>\n\n\nWhen collapsed, the internal surface of the bladder has numerous folds often called rugae<\/strong>, as with the stomach \u2014 allowing great expansion.<\/p>\n\n\n\nThe base of the bladder has a triangular surface formed by the paired urethral openings<\/strong> which convey urine from the kidneys through the ureters and the urethral opening<\/strong>, allowing urine to be passed during urination \u2014 this triangular region can be seen even in cadavers; compared to the rest of the bladder it is smooth, thanks to the lack of submucosa within its lining (the rest of the bladder wall has submucosa).<\/p>\n\n\n\n<\/a>Figure 3. Internal anatomy of the bladder<\/strong>\u00a0(Credit: OpenStax,\u00a0CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n<\/span>\nLigaments and connective tissue<\/h4>\n<\/span>\n\n\nThe bladder is surrounded by numerous ligaments, connective, and adipose tissue.<\/p>\n\n\n\n
- True ligaments<\/strong>\u00a0\u2014 Formed by the thickening of pelvic fascia:
- Lateral ligaments of the bladder<\/strong><\/li>
- Posterior ligaments of the bladder<\/strong><\/li>
- Puboprostatic ligament\u00a0<\/strong>in males<\/li>
- Pubovesical<\/strong>\u00a0and\u00a0vesicocervical\u00a0ligaments\u00a0<\/strong>in females<\/li>
- Median umbilical ligament<\/strong><\/li><\/ul><\/li>
- False ligaments\u00a0<\/strong>\u2014 Formed by reflections of peritoneum and have little to no function in holding the urinary bladder in place:
- Lateral reflections of peritoneum forming the paravesical fossae to the sides of the bladder<\/li>
- Posterior reflections of peritoneum forming the rectouterine (females) and vesicorectal (males) pouch<\/li>
- The median and medial umbilical folds<\/li><\/ul><\/li>
- Paracystium\u00a0<\/strong>describes the soft connective tissue and adipose tissue surrounding the bladder. It is found laterally, and transversed by the vesical venous plexus (see below).<\/li><\/ul>\n\n\n\n<\/a>
Figure 4. A cross-section showing the ligaments of the bladder and uterus<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Branches of the\u00a0internal iliac artery<\/strong>:
Superior vesicle artery<\/strong>
Inferior vesicle artery<\/strong>\u00a0in men,\u00a0vaginal artery<\/strong>\u00a0in females
Small branches coming from other nearby arteries (obturator\/inferior gluteal arteries) <\/td><\/tr>Venous drainage<\/strong><\/td>Vesical venous plexus<\/strong><\/strong>, drains into the internal iliac veins<\/td><\/tr>Innervation<\/strong><\/td>Intermesenteric plexus<\/strong>, from the greater, lesser, and least splanchnic (sympathetic), and vagus (parasympathetic).<\/td><\/tr>Lymphatic drainage<\/strong><\/td>Common and internal iliac lymph nodes <\/td><\/tr><\/tbody><\/table>Table 1. Neurovasculature of the bladder<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nUrethra<\/h3>\n<\/span>\n\n<\/span>\nDescription<\/h4>\n<\/span>\n\n\nThe urethra is a muscular tube that conveys urine out of the body. In males, it also conveys the products of ejaculation.<\/p>\n\n\n\n
The urethra starts at the internal urethral orifice at the apex of the bladder and ends as the external urethral orifice at the tip of the penis in males, and deep to the labia minora in females.<\/p>\n\n\n<\/span>\nCourse<\/h4>\n<\/span>\n\n\n- In males, the urethra is much longer than that of a female. It passes through the prostate, deep perineal pouch, and perineal membrane, before forming an angle as it enters the corpus spongiosum of the penis.
- In an erect penis, the penile urethra is straight, while in an unerect penis there\u2019s an additional angle formed by the resting penis.<\/li><\/ul><\/li>
- In females, the urethra is short (4cm) and passes parallel to the vagina directly to its opening between the labia minora anterior to the vaginal vestibule, without forming any angles.<\/li><\/ul>\n\n\n<\/span>\n
Parts<\/h4>\n<\/span>\n\n\nThe male urethra can be divided into 4 parts:<\/p>\n\n\n\n
- Preprostatic urethra<\/li>
- Prostatic urethra<\/li>
- Membranous urethra<\/li>
- Penile (spongy) urethra<\/li><\/ol>\n\n\n\n
In females, the urethra is generally not divided.<\/p>\n\n\n<\/span>\nSphincters<\/h4>\n<\/span>\n\n\n- In males, the internal urethral orifice is surrounded by a smooth muscle that acts as a sphincter (the internal urethral sphincter<\/strong>); this sphincter is absent in females.
- The role of the sphincter is to prevent the passage of urine during intercourse.<\/li><\/ul><\/li>
- The external urethral sphincter <\/strong>is a skeletal muscle found deep to the perineal membrane that allows voluntary control over the voiding process.
<\/li><\/ul>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\nBlood supply<\/strong><\/td>Urethral artery<\/strong> (branch of the internal pudendal artery)
Prostatic plexus, bulbar and dorsal arteries of the penis<\/strong> (males)
Vaginal artery<\/strong> (females) <\/td><\/tr>Venous drainage<\/strong><\/td>Urethral vein <\/strong>(draining into the internal pudendal vein)
Prostatic venous plexus <\/strong>(males)
Vaginal venous plexus <\/strong>(females) <\/td><\/tr>Innervation<\/strong><\/td>The prostatic urethra is innervated by the prostatic plexus<\/strong>, arising from the inferior hypogastric plexus<\/strong>
The rest of the urethra is innervated by the vesical plexus<\/strong> and the pudendal nerve<\/strong> <\/td><\/tr>Lymphatic drainage<\/strong><\/td> Internal iliac and deep inguinal nodes<\/td><\/tr><\/tbody><\/table>Table 2. Neurovasculature of the urethra<\/strong><\/figcaption><\/figure>\n\n\n<\/span>\nGallery<\/h4>\n<\/span>\n\n\n<\/a>Female urogenital system (Credit: Bioscope, HUG, DIP and Odile Fillod, CC BY-SA 4.0<\/a>)<\/figcaption><\/figure>\n\n\n\n<\/a>Male urogenital system (Credit: Bioscope, HUG, DIP and Odile<\/figcaption><\/figure>\n<\/span>
The base of the bladder has a triangular surface formed by the paired urethral openings<\/strong> which convey urine from the kidneys through the ureters and the urethral opening<\/strong>, allowing urine to be passed during urination \u2014 this triangular region can be seen even in cadavers; compared to the rest of the bladder it is smooth, thanks to the lack of submucosa within its lining (the rest of the bladder wall has submucosa).<\/p>\n\n\n\n The bladder is surrounded by numerous ligaments, connective, and adipose tissue.<\/p>\n\n\n\n The urethra is a muscular tube that conveys urine out of the body. In males, it also conveys the products of ejaculation.<\/p>\n\n\n\n The urethra starts at the internal urethral orifice at the apex of the bladder and ends as the external urethral orifice at the tip of the penis in males, and deep to the labia minora in females.<\/p>\n\n\n<\/span>\n The male urethra can be divided into 4 parts:<\/p>\n\n\n\n In females, the urethra is generally not divided.<\/p>\n\n\n<\/span>\n<\/a>Ligaments and connective tissue<\/h4>\n<\/span>\n\n\n
<\/a>Neurovasculature<\/h4>\n<\/span>\n\n\n
Blood supply<\/strong><\/td> Branches of the\u00a0internal iliac artery<\/strong>:
Superior vesicle artery<\/strong>
Inferior vesicle artery<\/strong>\u00a0in men,\u00a0vaginal artery<\/strong>\u00a0in females
Small branches coming from other nearby arteries (obturator\/inferior gluteal arteries) <\/td><\/tr>Venous drainage<\/strong><\/td> Vesical venous plexus<\/strong><\/strong>, drains into the internal iliac veins<\/td><\/tr> Innervation<\/strong><\/td> Intermesenteric plexus<\/strong>, from the greater, lesser, and least splanchnic (sympathetic), and vagus (parasympathetic).<\/td><\/tr> Lymphatic drainage<\/strong><\/td> Common and internal iliac lymph nodes <\/td><\/tr><\/tbody><\/table> Urethra<\/h3>\n<\/span>\n\n<\/span>\n
Description<\/h4>\n<\/span>\n\n\n
Course<\/h4>\n<\/span>\n\n\n
Parts<\/h4>\n<\/span>\n\n\n
Sphincters<\/h4>\n<\/span>\n\n\n
<\/li><\/ul>\n\n\n<\/span>\nNeurovasculature<\/h4>\n<\/span>\n\n\n
Blood supply<\/strong><\/td> Urethral artery<\/strong> (branch of the internal pudendal artery)
Prostatic plexus, bulbar and dorsal arteries of the penis<\/strong> (males)
Vaginal artery<\/strong> (females) <\/td><\/tr>Venous drainage<\/strong><\/td> Urethral vein <\/strong>(draining into the internal pudendal vein)
Prostatic venous plexus <\/strong>(males)
Vaginal venous plexus <\/strong>(females) <\/td><\/tr>Innervation<\/strong><\/td> The prostatic urethra is innervated by the prostatic plexus<\/strong>, arising from the inferior hypogastric plexus<\/strong>
The rest of the urethra is innervated by the vesical plexus<\/strong> and the pudendal nerve<\/strong> <\/td><\/tr>Lymphatic drainage<\/strong><\/td> Internal iliac and deep inguinal nodes<\/td><\/tr><\/tbody><\/table> Gallery<\/h4>\n<\/span>\n\n\n
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