Paravesical space
The
anatomical compartments and their connections as demonstrated by ectopic air. The same patient as in Fig. 13b. Fournier gangrene in a 67-year-old diabetic man, with extensive arteriosclerosis, already submitted to aortic bifemoral bypass years ago, still permeable (red circles – patent common femoral bypass grafts located anteriorly to native arteries, occluded on the left). Contrast-enhanced CT scan at level of acetabular dome shows endopelvic fascia and extraperitoneal pelvic spaces. Endopelvic fascia and its two layers are illustrated. The parietal layer covers the elevator muscle of anus and coccygeus (pelvic diaphragm) and the intrapelvic portions of the internal obturator and the piriformis muscles. The visceral layer covers inferior segments of the urinary bladder, lower third of the ureters, uterus, vagina and seminal vesicles; it forms a continuous line enveloping the perirectal fat, the mesorectal fascia. Pelvic spaces. Prevesical space is bordered by transversalis fascia anteriorly and umbilicovesical fascia posteriorly. Paravesical and presacral spaces are limited by parietal and visceral sleeves of the endopelvic fascia. Perivesical space is surrounded by umbilicovesical fascia and rectovesical septum. Perirectal space is involved by the rectal fascia and separated from the perivesical space by the rectovesical septum
The paravesical spaces are paired avascular spaces of the pelvis. The paravesical spaces generally contain fat, but can become filled with ascites, blood, or other substances during pathological processes.
Gross anatomy
Boundaries
- superior: lateral umbilical folds
- inferior: pubocervical fascia as it inserts into the tendinous of the levator ani muscle
- anterior: arcuate rim of the ileum
- posterior: endopelvic fascial sheath covering the internal iliac artery and vein; cardinal ligament divides the paravesical spaces from the pararectal spaces
- medial: bladder pillars
- lateral: pelvic walls, obturator internus and levator ani muscles
Relations
- continuous with the retropubic space (space of Retzius), which lies medially
- continuous with the infrarenal space, which lies superiorly