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When
empty, the bladder lies on the pelvic floor surrounded by
extraperiotoneal fatty tissue, posterior to the pubic bones. As it
fills, it ascends in the extraperitoneal fatty tissue and enters the
greater pelvis, reaching as high as the level of the umbilicus when
full. In males, it is situated anterior to the rectum and superior to
the prostate gland. In females, it is anterior to the vagina and
anteroinferior to the uterus.
The anterior portion of the bladder, the apex, is connected
to the medial umbilical ligament (vestigal urachus). The superior
surface is covered with peritoneum. There are two inferolateral
surfaces, a base, and a neck.
The body of the bladder extends from the apex to the
posterior end, the fundus. The ureters enter the bladder through the
internal ureteric orifices at the posterolateral angles of the trigone,
which is located at the posterior base of the bladder and extends
inferiorly to its anteroinferior angle at the neck of the bladder and
the internal urethral orifice.
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Unenhanced CT scan
through a normal bladder (B) shows a normal fluid density structure
(less than 10 Hounsfield units on CT density scale).
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3D reconstructed image
of a normal bladder in the sagittal plane following CT IVP. On
this delayed image 10 minutes following IV contrast administration,
excreted contrast fills an otherwise normal bladder (B).
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Transverse image through
a normal bladder (calipers "x" and "+" outline the bladder wall) using
ultrasound shows normal anechoic structure (anechoic = no echoes =
black).
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