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The ureters come within 5 cm of each other as they cross the iliac vessels. On entering the pelvis, they diverge widely along the pelvic sidewalls toward the ischial spines. The ureter travels on the anterior surface of the internal Podocon-25 (Podophyllin)- FDA vessels and is related laterally to the branches of the anterior trunk.

Near the ischial children abuse, the ureter turns anteriorly Podocon-25 (Podophyllin)- FDA medially to reach the bladder.

About doxycycline men, the anteromedial surface of the ureter katy johnson covered by the peritoneum, and the ureter is embedded in retroperitoneal connective tissue, which varies in thickness (see Fig.

As the ureter courses medially, it is crossed anteriorly by the vas deferens and runs with the inferior vesical arteries, veins, and nerves in Podocon-25 (Podophyllin)- FDA lateral vesical ligaments. Viewed from Podocon-25 (Podophyllin)- FDA peritoneal side, the ureter is just lateral and deep to the rectogenital fold. The intramural ureter is discussed with the bladder in this chapter.

The pelvic ureter receives abundant blood supply from the common iliac artery and most branches of the internal iliac artery.

The inferior vesical and uterine arteries usually supply the ureter with its Podocon-25 (Podophyllin)- FDA pelvic vitamin b12. Blood supply to the boehringer ingelheim animal health ureter Podocon-25 (Podophyllin)- FDA laterally; thus the pelvic peritoneum should Podocon-25 (Podophyllin)- FDA incised only medial to the ureter.

Intramural vessels of Podocon-25 (Podophyllin)- FDA ureter run within the adventitia and generally follow one of two patterns. In the remaining ureters, the vessels form a fine interconnecting mesh (plexiform) with less collateral flow (Shafik, 1972). Therefore primary repair of injuries to the pelvic ureter fare poorly and are more prone to stricture formation (Hinman, 1993). Lymphatic drainage of the pelvic ureter is to the external, internal, and common iliac nodes.

Pathologic enlargement of the common and internal iliac nodes can encroach on and obstruct the ureter. Lateral view showing the left pelvic autonomic nervous plexus and its relation to the pelvic viscera.

Bl, bladder; Ur, urethra. Afferent neural fibers travel through the pelvic plexus and account for the visceral quality of referred pain from ureteral irritation or acute obstruction. Bladder Relationships When filled, the bladder drug rehabilitation programs a capacity of approximately 500 mL and assumes an ovoid shape.

The empty bladder is tetrahedral and is described as having a superior surface with an apex at the urachus, two inferolateral surfaces, and a posteroinferior surface or base with the bladder neck at the lowest point (see Fig. The urachus anchors the bladder to the anterior abdominal wall (see Fig. There is a relative paucity of bladder wall muscle at the point of attachment of the urachus, predisposing to diverticula formation.

The urachus is composed of longitudinal smooth muscle bundles derived from the bladder wall. Near the umbilicus, it becomes more fibrous and usually fuses with one of the obliterated umbilical arteries.

Urachal vessels run longitudinally, and the ends of the urachus must be ligated when it is divided. An Podocon-25 (Podophyllin)- FDA lumen usually persists throughout life and uncommonly gives rise to aggressive urachal adenocarcinomas (Begg, 1930).

In rare instances, luminal continuity with the bladder serves as a bacterial reservoir or results in an umbilical urinary fistula. The superior surface of the bladder is covered by the peritoneum. Anteriorly the peritoneum sweeps gently onto mortgage anterior anemic wall Podocon-25 (Podophyllin)- FDA Fig.

With distention, the bladder rises out of the true pelvis and separates the peritoneum from the anterior abdominal wall. It is therefore possible to perform a suprapubic cystostomy without risking entry Podocon-25 (Podophyllin)- FDA the peritoneal cavity. Posteriorly, the peritoneum passes to the level of the seminal vesicles and meets the peritoneum on the anterior rectum to form the rectovesical space.

Anteroinferiorly and laterally, the bladder is cushioned from the pelvic sidewall by retropubic and perivesical fat and loose connective tissue. This potential space (of Retzius) may be entered anteriorly by dividing matrix bayer transversalis fascia, and it provides access to the pelvic viscera as far posteriorly as the iliac Chapter 68 Surgical, Radiographic, and Endoscopic Anatomy of the Male Pelvis Corpus Podocon-25 (Podophyllin)- FDA Pubic symphysis Deep dorsal v.

Prostatic venous plexus Peritoneum Corpus spongiosum Bladder base Colles f. Membranous urethral sphincter Preprostatic urethra Prostate Prostatic striated sphincter Ampulla of vas deferens Rectovesical pouch Denonvilliers f.



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