posterior wall of urinary bladder

The posterior wall of the urinary bladder is the most posterior wall of the bladder, facing the rectum in males and the uterus and vagina in females. It forms the back surface of the bladder opposite to the anterior wall.

In males, the posterior wall of the urinary bladder is adjacent to the rectum, with the rectovesical pouch of peritoneum intervening superiorly. Below the peritoneal reflection, the bladder's posterior wall is separated from the rectum by Denonvilliers' fascia (rectovesical fascia) and the seminal vesicles and vas deferens lie between the two structures.

In females, the posterior wall of the urinary bladder is adjacent to the uterus and vagina. The vesicouterine pouch of peritoneum separates the bladder from the uterus superiorly. The posterior bladder wall and anterior vaginal wall are closely applied in the lower portion, which is relevant in obstetric injuries and fistula formation.

During radical prostatectomy for prostate cancer, surgeons must carefully dissect the posterior wall of the bladder away from the prostate. Denonvilliers' fascia provides a surgical plane between the bladder-prostate unit and the rectum. The seminal vesicles and vas deferens, which lie posterior to the bladder, must also be carefully identified and managed.

A vesicovaginal fistula is an abnormal communication between the posterior wall of the urinary bladder and the anterior vaginal wall. It is most commonly caused by obstetric trauma, particularly prolonged obstructed labor, or by pelvic surgery. The fistula results in uncontrolled urinary leakage through the vagina and requires surgical repair.