we
find it sinking deeply into the hollow of the pelvis behind the bladder,
so as to form the sides of the recto-vesical pouch; but when traced over
the summit of the bladder, this organ is seen to have the membrane
reflected upon it, almost immediately below the pelvic brim. At the
situations where the peritonaeum becomes reflected in front, laterally,
and behind, upon the sides of the bladder, the membrane is thrown into
folds, which are named "false ligaments." The pelvic fascia, in being
reflected to the bladder from the front and sides of the pelvis, at a
lower level than that of the peritonaeum, forms the "true ligaments." In
addition to these ligaments, which serve to keep the base and front of
the bladder fixed in the pelvis, other structures, such as the ureters,
K, the vasa deferentia, I, the hypogastric cords, the urachus, and the
bloodvessels, embrace the organ in various directions, and act as
bridles, to limit its expansion more or less in all directions, but
least so towards its summit, which is always comparatively free.
The neck and outlet of the bladder, V, are situated at the anterior part
of its base, and point towards the subpubic space. The prostate gland,
V, surrounds its neck, and occupies a position behind and below the
pubic arch, D, and in front of the rectum, W. The gland, V, being of a
rounded form and dense structure, can be felt in this situation by the
finger, passed upwards through the bowel. The prostate is suspended from
the back of the pubic arch by the anterior true ligament of the bladder,
and at its forepart, where the membranous portion of the urethra
commences, this passes through the deep perinaeal fascia, X. The
anterior fibres of the levator ani muscle embrace the prostate on both
its sides. Behind the base of the prostate, the ureter, K, is seen to
enter the coats of the bladder obliquely, whilst the vas deferens, I,
joined by the vesicula seminalis, L, penetrates the substance of the
prostate, V, at its lower and back part, which lies in apposition with
the rectum.
The rectum, W C, at its middle and upper parts, occupies the hollow of
the sacrum, A Q, and is behind the bladder. The lower third of the
rectum, W, not being covered by the peritonaeum, is that part on which
the various surgical operations are performed. At its upper
three-fifths, the rectum describes a curve corresponding to that of the
sacrum; and if the bladder be full, its convex back part presses the
bow
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