Chap, xvm.) THE BLADDER. 399 



wall. The difference between the two parts is well 

 shown in frozen sections (Symington). 



The ureters run for three-quarters of an inch in 

 the muscular wall of the viscus, and their oblique 

 course, together with the action of the muscular tissue 

 about them, tends to prevent regurgitation of urine, 

 In cases of retention the ureters become distended ; 

 but this is due rather to accumulation of urine within 

 them than to its reflux from the bladder. 



In cases of great distension of the bladder the 

 neck of the viscus is opened up by the pressure from 

 within, and the patient exhibits the feature of over- 

 flow of urine. 



The female bladder is less capacious than that 

 of the male. Its neck is situate a trifle nearer to the 

 symphysis than it is in the male, and lies in a hori- 

 zontal line continued back from the border of the 

 symphysis. There being no prostate, the neck of the 

 bladder is very distensible, and this fact, taken in 

 connection, with the shortness and dilatability of the 

 urethra, allows of most stones being extracted by 

 forceps without cutting. By simple dilatation, stones 

 of a diameter of three-quarters of an inch have been 

 removed. Through the dilated urethra the orifices of 

 the ureters can be seen and examined. The intimate 

 relation of the bladder to the vagina allows it to be 

 examined well from the latter passage, and the com- 

 parative thinness of the dividing wall serves to explain 

 the frequency of vesico-vaginal fistulse. Strange 

 foreign bodies have been introduced into the female 

 bladder, such as hair-pins, crochet hooks, sealing-wax, 

 penholders, and the like. 



The orifice of the ureter is 3 cm. from the cervix 

 uteri, and 4 cm. from the vesical opening of the 

 urethra. Its close relation to the cervix renders it 

 liable to injury in supravaginal amputation of that 

 part, and in certain operations on the uterus. 



