• In both male and female the urinary bladder is a hollow, muscular reservoir for storing the

urine produced by the kidneys until urination occurs.

• It lies in the true pelvis posterior and superior to the pelvic bones, from which it is
separated by the retropubic space.

• The urinary bladder is very extensible and relatively free within the extraperitoneal
subcutaneous fatty tissue.

• When full, the urinary bladder pushes up through the extraperitoneal fatty tissue of the
anterior abdominal wall, extending into the false pelvis, and may reach as far as the
umbilicus.

The urinary bladder is rounded in life, but in cadavers appears as having the following four
distinct sides:

Fundus

• The fundus or base is triangular in shape.

• In females, it is in contact with the anterior vaginal wall, and in males with the rectum,
seminal vesicles, and ductus deferens.

Superior surface

• The superior surface is triangular in shape.

• It is completely covered by peritoneum in males and in contact with the sigmoid colon
and the terminal aspects of the ilium.

• In the female, the aspect not covered by peritoneum is reflected to the uterus.

Inferolateral surfaces

• There are two inferolateral surfaces, each of which is separated by a retropubic fat pad
from the pubis and pubovesical ligament in females or the puboprostatic ligament in
males.

• They are in contact with the fascia covering the levator ani muscle.

• The walls of the urinary bladder are composed of the detrusor muscle, forming the
urinary sphincter at the neck of the bladder.

• Internally, they are covered by mucous membrane, which is loosely attached to the wall
to allow distension, and in the empty bladder, falls into folds or rugae.

Trigone

• A triangular region called the trigone at the base of the bladder is firmly attached to the
muscular wall and always appears smooth.

• This is the point of entry of the ureters and thus remains rigid to avoid tearing these
ducts.
Blood supply

• Superior vesical artery.

• Branches from the umbilical artery.

• Vaginal arteries (in females).

• Inferior vesical arteries (in males).

• Small branches of the obturator and the inferior gluteal arteries.

Venous drainage

• Venous plexus on the inferolateral surface.

• It drains to the vaginal venous plexus in females and the prostatic venous plexus in
males.

Innervation

• Nerve fibers from the vesical plexus.

• Least, lumbar, and sacral splanchnic nerves from T10 to L2 (sympathetic innervation).

• Pelvic splanchnic nerves from S2 to S4 in the nervi erigentes (parasympathetic

innervation).

• The detrusor muscle of the bladder walls is particularly rich in parasympathetic nerve
fibers, while the trigonal area has more sympathetic fibers.

• The bladder neck has the greatest density of nerve fibers and has mostly
parasympathetic with some sympathetic supply in the female.

• The opposite occurs in the male where sympathetic fibers are more abundant, reflecting
the close relationship with the sympathetically innervated genital structures (seminal
vesicles, prostate, and ductus deferens).