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General Surgery
Urinary Bladder
Built from Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
What’s inside
12 sections · 134 slides
Overview
- Scope of this topic
Embryogenesis and congenital anomalies
- Division of the cloaca
- Fate of the allantois and formation of the urachus
- Descent of the bladder from abdomen to pelvis
- Development of the bladder
- Malformations of the urachus
- Exstrophy of the bladder
- Development of the infraumbilical wall and of exstrophy
- Reference table on the anomalies
- Anomalies of the Bladder and Urethra
- Anomalies of the Bladder and Urethra (continued)
Topography and relations
- Determinants of bladder position and shape
- Capacity of the adult bladder
- Volume thresholds and paediatric capacity
- Empty and full bladder
- Empty bladder in the male pelvis
- Full bladder and the extraperitoneal approach
- Four surfaces, four ducts and four angles
Spaces, ligaments and fixation
- The prevesical space of Retzius
- Boundaries and lining of the space of Retzius
- Two compartments anterior to the bladder
- Fascial spaces and laminae around bladder, prostate and rectum
- Ligaments and pillars of the bladder
- The bladder and its ligaments
- Ligaments of the Bladder
- Ligaments of the Bladder (continued)
- Retrovesical space in the male
- Contents between bladder fundus and rectum
- Male pelvic peritoneum in paramedian section
- Female pelvic peritoneum in paramedian section
- Pelvic fascia of the male in median sagittal section
- Fixation of the bladder
Bladder wall, trigone and vesical neck
- The four coats of the bladder wall
- The detrusor as a surgical entity
- Structure of the bladder wall
- Detrusor instability and the urgency syndrome
- Suggested Etiologic Factors in the Hyperactive Bladder
- Anatomy of the trigone
- Superficial and deep layers of the trigone
- Tanagho on the continuity of ureter and trigone
- Ureterovesical junction and trigone
- The vesical neck and internal sphincter
- The urethral sphincter in the female
- Obturator fascia in cystourethropexy
Vascular supply and lymphatic drainage
- Arterial supply of the bladder
- Arterial supply of the bladder
- Venous drainage of the bladder
- Venous drainage and the plexus of Santorini
- Lymphatic drainage of the bladder wall
- Regional nodal drainage and its surgical relevance
Innervation and control of micturition
- Overview of bladder innervation
- de Groat on central regulation
- Sympathetic pathway to the bladder
- Parasympathetic pathway to the bladder
- Vesical pain pathways
- Current view of pain from the pelvic viscera
- Pelvic nerves and plexuses
- Nerve supply of the bladder and urethra
- Somatic innervation and the pudendal nerve
- Fowler on the extent of bladder innervation
- Levels of micturition control
- Descending pathway and innervation of the bladder
- Voluntary initiation and interruption of micturition
- Receptor distribution in bladder, urethra and pelvic floor
- Internal and external sphincters compared
- Continence mechanism in the female
Neurogenic and unstable bladder
- The unstable bladder
- Neurogenic bladder in meningomyelocele
- Two practical types of neuropathic bladder
- Efferent (spastic) neurogenic bladder
- Spastic neurogenic bladder
- Afferent (flaccid) neurogenic bladder
- Volumes tolerated in the flaccid bladder
- Flaccid neurogenic bladder
- Management of the flaccid neurogenic bladder
Histology and physiology of the urothelium
- The vesical mucosa
- Four properties of the urothelial barrier
- Loss of the urothelial barrier in infectious cystitis
- Regional control of bladder musculature
- The dual physiologic destiny of the bladder
- Membranous urethra of the adult male
- The female urethra in sagittal section
Surgery of the urinary bladder
- Surgery for bladder exstrophy
- Bladder injuries
- Bladder fistulas
- Bladder calculi
- Cystoscopy
- Partial cystectomy
- Total (radical) cystectomy
- Urinary diversion after cystectomy
- Incisions for bladder surgery
Anatomic complications of radical cystectomy
- Anatomic knowledge required for radical cystectomy
- Anatomic complications of radical cystectomy
- Bleeding of arterial or venous origin
- Level of internal iliac ligation and buttock ischaemia
- Ligation of the anterior pedicles for cystectomy
- Obturator nerve injury
- Palpating the obturator structures in the retropubic space
- Obturator nerve and vessels in the right pelvis
- Rectal injury
- Prevention of impotence: the neurovascular bundle
- Prostate in cross section with the neurovascular bundle
- Surgical plane in radical prostatectomy
- Incision in the lateral pelvic fascia that spares the bundle
- Correct site for ligation of the lateral pedicle
- Urinary incontinence after radical cystectomy
- Vaginal cuff complications
- Urinary diversion complications and wound dehiscence
History table and key points
- How to read the historical table
- Anatomic and Surgical History of the Bladder
- Anatomic and Surgical History of the Bladder (continued)
- Anatomic and Surgical History of the Bladder (continued)
- Anatomic and Surgical History of the Bladder (continued)
- Anatomic and Surgical History of the Bladder (continued)
- Key anatomical points
- Key clinical and operative points
- Authorities cited in the text
- Authorities cited in the text (continued)
- Authorities cited in the text (continued)
- Authorities cited in the text (continued)
- Authorities cited in the text (continued)
- Skandalakis' Surgical Anatomy: The Embryologic and Anatomic Basis of Modern Surgery
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