PELVIC FASCIA. 785 



prostate and neck of the bladder may be cut through, which allows of infiltration 

 of urine behind the pelvic fascia into the loose cellular tissue between the bladder 

 and rectum, instead of escaping externally ; diffuse inflammation is consequently 

 set up, and peritonitis from the close proximity of the recto-vesical peritoneal 

 fold is the consequence. If, on the contrary, the prostate is divided in front of 

 the base of the gland, the urine makes its way externally, and there is no danger 

 of any infiltration taking place. 



During the operation, it is of great importance that the finger should be passed 

 into the bladder before the staff is removed ; if this is neglected, and the incision 

 made through the prostate and neck of the bladder be too small, great difficulty 

 may be experienced in introducing it afterwards ; and in the child, where the 

 connections of the bladder to the surrounding parts are very loose, the force made 

 in the attempt is sufficient to displace the bladder up into the abdomen, out of the 

 reach of the operator. Such a proceeding has not unfrequently occurred, pro- 

 ducing the most embarrassing results, and total failure of the operation. 



Fig. 395. Side View'of the Pelvic Viscera of the Male Subject, showing the Pelvic 



and Perineal Fasciae. 



It is necessary to bear in mind that the arteries in the perineum occasionally 

 take an abnormal course. Thus, the artery of the bulb, when it arises, as some- 

 times happens, from the pudic, opposite the tuber ischii, is liable to be wounded 

 in the operation for lithotomy, in its passage forwards to the bulb. The accessory 

 pudic may be divided near the posterior border of the prostate gland, if this is 

 completely cut across; and the prostatic veins, especially in people advanced in 

 life, are of large size, and give rise when divided to troublesome hemorrhage. 



PELVIC FASCIA. 



The Pelvic Fascia is a thin membrane which lines the whole of the cavity 01 

 the pelvis, and is continuous with the transversalis and iliac fasciae. It is attached 

 50 



