Revision 21 for 'Urinary bladder'

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Urinary bladder

The urinary bladder (more commonly just called the bladder) is a distal part of the urinary tract and is an extra-peritoneal structure located in the true pelvis.

Gross anatomy

The bladder has a triangular shape with a posterior base, an anterior apex and an inferior neck with two inferolateral surfaces. It is lined with a rough, trabeculated transitional cell epithelium except at the trigone.

The trigone is a triangular area of smooth mucosa found on the internal surface of the base. The superolateral angles are formed by the ureteric orifices and the inferior angle is formed by the internal urethral orifice.

The urethra arises from the neck of the bladder and is surrounded by the internal urethral sphincter.

As the bladder fills with urine it becomes ovoid in shape and extends superiorly into the abdominal cavity.

Relations - male
Relations - female 2

Blood supply

Nerve supply

  • vesical nerve plexus

Lymphatic supply

  • accompanies blood vessels to the internal iliac lymph and para-aortic nodes

Variant anatomy

  • double bladder - receives ipsilateral ureter and has separate urethra
  • septation - septum may divide the bladder internally into two or more compartments
  • agenesis - persistence of the cloaca
  • ureterocoele - dilation of the intravesical part of the ureter

Radiological appearance

Plain radiography

The bladder may be seen as a rounded soft tissue mass 1.


Cystography can be performed where the bladder is filled with contrast either via an antegrade or retrograde technique.


Bladder wall is best assessed with this modality - it should not exceed 3-5mm in thickness. Ureteric jets can be assessed using Doppler ultrasound 1.

  • T1W - bladder wall and contents are homogenous low signal
  • T2W - bladder wall is low signal and urine is high signal, allowing for contrast between the two 1

Related pathology

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