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The urinary bladder
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
The abdomen is opened through a midline incision extending down to the symphysis pubis. The liver and the retro- peritoneum are checked for evidence of metastases, and the operability of the bladder is assessed. A bilateral pelvic lymph- adenectomy is performed, removing external iliac nodes, internal iliac nodes and the nodes in the obturator fossae. Some surgeons will remove lymph nodes up to the aortic bifurcation or higher with some evidence of improved long-term oncological outcomes. The vessels passing to the bladder from the side wall of the pelvis are ligated and divided; these include the obliterated hypogastric vessels, the superior vesical artery, the middle vesical veins, and the inferior vesical arteries and veins. The ureters are then divided. The posterior ligaments extending from the pararectal area to the back of the bladder are ligated and divided, and the layer posterior to Denonvil- liers' fascia is opened up. The endopelvic fascia is then divided on each side and the puboprostatic ligaments are divided. A ligature is passed between the dorsal vein complex and the urethra, and the former is ligated and divided. The urethra is then mobilised and divided. The ligaments lateral to the prostate are divided and the bladder is removed. In women, the uterus and anterior vaginal wall need to be included. Women must be counselled about the loss of ovarian and uterine function.
Urologic procedures
Published in J. Richard Smith, Giuseppe Del Priore, Robert L. Coleman, John M. Monaghan, An Atlas of Gynecologic Oncology, 2018
Padraic O’Malley, Peter N. Schlegel
The superior and inferior vesical arteries, both branches from the anterior internal iliac artery, provide the majority of the vascular supply to the bladder. The ureter takes its supply from the vessels it is in proximity to, namely the abdominal aorta, the internal and external iliacs, and the vesical arteries. It is helpful to remember during injury and reconstruction that the majority of the vascular supply for the distal ureter comes from the lateral aspect, while more proximately it arises medial to the ureter.
Simplified anatomy of the vesicourethral functional unit
Published in Jacques Corcos, David Ginsberg, Gilles Karsenty, Textbook of the Neurogenic Bladder, 2015
Saad Aldousari, Jacques Corcos
The superior and inferior vesical arteries are branches of the internal iliac arteries. The obturator and gluteal arteries also participate in the bladder arterial supply. In females, an additional branch is derived from the uterine and vaginal arteries. Venous drainage forms a complex, extensive network around the bladder and into a plexus on its inferolateral face, ending in the internal iliac veins.
Introduction of prostate artery embolization (PAE) in Sweden
Published in Scandinavian Journal of Urology, 2019
A Foley balloon placed in the bladder was filled with 10 ml iodinated contrast medium (Visipaque 140 mg I/ml mixed with 50% saline solution) in order to visualize the level of the arteries to the prostate gland. In an interventional radiology angio suite (FD20 digital subtraction angiography unit; Philips, Best, The Netherlands) in local anesthesia, through right femoral approach, selective DSA with non-ionic contrast material (Visipaque 140 mg I/ml; GE healthcare, Chicago, Illinois, USA) of both iliac arteries, followed by catheterization with 4 F glide cobra catheter (Terumo, Tokyo, Japan) and catheterization of both inferior vesical arteries with micro catheters (Progreat 2.0, Terumo, Tokyo, Japan) (Figure 1). Selective angiogram with 3–5 ml contrast medium to visualize the blood supply to the prostate and Cone-Beam CT (CBCT) to ensure proper placement of the micro catheter tip in the prostate artery (Figure 2) was performed.
Selective embolisation for intractable bladder haemorrhages: A systematic review of the literature
Published in Arab Journal of Urology, 2018
Diaa-Eldin Taha, Ahmed A. Shokeir, Omar A. Aboumarzouk
The most reported complication was post-embolisation syndrome [13,23]. Post-embolisation syndrome involves nausea, vomiting, gluteal pain, and fever due to tissue necrosis. It can be managed conservatively with symptomatic medications. Transient acute tubular necrosis also is a common reported complication, caused by contrast medium. Other side-effects can occur, e.g. fever, gluteus pain, nausea, and exterior genital oedema [15]. Some complications were reported specific to the vessel approached, e.g. mild transient gluteal claudication when using the inferior mesenteric approach [2]. Brown-Sequard’s syndrome can occur because of the presence of anastomoses between the vesical arteries and the sacral lateral arteries, which has to be checked during angiography, bladder necrosis, gluteal paresis or skin necrosis [23,27[28][29]–30].