THE BLADDER. 227 



In front of the bladder, between it and the pubes, is 

 a quantity of lax cellular tissue, the reflexion of the 

 peritoneum from its anterior surface, and the non-attach- 

 ment of this membrane to it allows of its dilatation, and 

 is of great practical importance in percussing the blad- 

 der. It is here that puncture over the pubes and the 

 " high " operation of lithotomy are practiced, but the 

 frequency of urinary infiltration is greatly against the 

 latter proceeding. Its posterior surface is entirely cov- 

 ered by peritoneum, and corresponds in the male to the 

 rectum, and in the female to the vagina, and is in relation 

 with some convolutions of the small intestine, which lie 

 in the recto-vesical pouch. Laterally, the peritoneum is 

 applied to the bladder above and behind the crossing of 

 the obliterated umbilical artery, around which it is re- 

 flected. The vasa deferentia pass along the side, cross 

 the obliterated umbilical artery, and lie to the inner side 

 of the ureter. 



The base of the bladder lies upon the anterior surface 

 of the rectum, from which it is separated merely by a 

 thin layer of cellular tissue in the middle, and laterally 

 by the vesiculse seminales and vasa deferentia, the former 

 of which are intimately adherent to it, and form two 

 sides of a triangle, the base of which is directed upwards 

 and backwards, and its apex towards the prostate. It 

 is at this spot that puncture of the bladder by the rec- 

 tum is performed. The neck of the bladder is sur- 

 rounded by the prostate, and is directed obliquely for- 

 wards and downwards. 



The cavity of the bladder presents at its base the tri- 

 gone vesiece, an equilateral triangle formed by the oblique 

 openings of the ureters posteriorly, and by the urethra 

 anteriorly. It is through this triangular space that the 



