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The bladder is a musculo-membranous organ that serves as a reservoir for urine, allowing for its accumulation and storage until micturition.
The bladder has a flattened shape when empty, with three surfaces: a superior surface, an antero-inferior surface, and a postero-inferior surface. It also has three borders: one posterior and two lateral, an anterior apex, a posterior fundus (or base), and a neck that continues into the urethra.
The capacity of the bladder is generally larger in females than in males. On average, the bladder can hold about 300 cm³ in adults but can expand to accommodate 2 to 3 liters when full.
Internally, the bladder is contained within a fibrous pouch and features three orifices, two angles, a posterior border, and lateral borders. The urethral orifice is anterior and median, surrounded by a sphincter, while the ureteral orifices are lateral and slit-like.
In males, the structures located posterior to the bladder include the terminal portions of the deferent ducts, seminal vesicles, and the prostate gland, which is situated anterior to the rectum.
The vesical fossa, or retrovesical space, is significant as it separates the bladder from the rectum in males and contains connective tissue that allows for movement and expansion of the bladder.
The bladder receives its blood supply primarily from the internal iliac artery, with the superior vesical arteries being branches of the umbilical and obturator arteries.
When the bladder is empty, it is located in the pelvic cavity; however, when full, it expands and rises into the abdominal cavity, altering its position and relationships with surrounding structures.
When the bladder is empty, its lateral relationships include the umbilical artery and, in males, the deferent duct. When full, it is related to the lateral vesical recesses.
In females, the bladder is separated from the vagina by the vesicovaginal septum, which is a connective tissue structure that provides support and separation between these two organs.
The internal urethral sphincter is a muscle that surrounds the urethral orifice and helps to maintain urinary continence by preventing involuntary leakage of urine from the bladder.
The bladder anatomy differs between males and females primarily in its size, position, and relationships with adjacent structures, such as the prostate in males and the uterus in females.
The rectovesical pouch is clinically significant as it can accumulate fluid or pus in cases of infection or disease, and it is a common site for surgical access in male pelvic surgeries.
The bladder's innervation, primarily from the pelvic splanchnic nerves, regulates bladder contraction and relaxation, influencing the process of micturition and urinary control.
The apex of the bladder is associated with the urachus, a fibrous remnant of the allantois, which extends from the bladder to the umbilicus.
The bladder plays a crucial role in the urinary system by storing urine produced by the kidneys, allowing for controlled release during urination, and maintaining fluid balance in the body.
Potential complications of bladder surgery include infection, bleeding, injury to surrounding organs, urinary incontinence, and the formation of scar tissue that may affect bladder function.
The bladder is positioned anterior to the rectum and posterior to the pubic symphysis, with the superior surface of the bladder in contact with the loops of the small intestine and the sigmoid colon.
The bladder adapts to changes in urine volume through its elastic walls, which allow it to stretch and accommodate varying amounts of urine while maintaining pressure for effective micturition.
The vesical arteries are significant for bladder health as they provide essential blood supply for oxygen and nutrients, and any compromise in this supply can lead to bladder dysfunction or ischemia.
Lymphatic drainage from the bladder primarily occurs through lymph nodes associated with the internal iliac vessels, which play a role in immune response and fluid balance.
The external urethral sphincter is a voluntary muscle that surrounds the urethra and allows for conscious control over urination, providing an additional layer of urinary continence.