anterior wall of urinary bladder

The anterior wall of the urinary bladder is the most anterior wall of the bladder, facing the pubic symphysis and the anterior abdominal wall. It forms the front surface of the bladder and is separated from the pubic bone by the retropubic space (space of Retzius).

The retropubic space (space of Retzius) is the extraperitoneal space between the anterior wall of the urinary bladder and the pubic symphysis and anterior abdominal wall. This space contains loose connective tissue and fat and provides a surgical corridor for retropubic prostatectomy, bladder neck suspension procedures, and suprapubic catheter placement.

No, the lower portion of the anterior wall of the urinary bladder is not covered by peritoneum. Only the superior surface of the bladder (dome) is covered by peritoneum. This extraperitoneal location of the anterior wall allows surgeons to enter the retropubic space and access the bladder without entering the peritoneal cavity.

Blunt or penetrating pelvic trauma can cause extraperitoneal bladder rupture involving the anterior and lateral walls of the bladder, often associated with pelvic fractures. Bone fragments from fractured pelvic rings can directly lacerate the anterior bladder wall. This type of injury typically presents with inability to void, hematuria, and pelvic pain.

The anterior wall of the bladder is accessed through a midline or Pfannenstiel incision. After opening the anterior abdominal wall, the surgeon enters the retropubic space by dissecting behind the pubis without opening the peritoneum. This extraperitoneal approach allows cystotomy, placement of suprapubic tubes, or retropubic prostate procedures.