400 SURGICAL APPLIED ANATOMY. [Chap. xvm. 



The bladder in the child is egg-shaped, and 

 its vertical axis is relatively much greater than it is 

 in the adult. The larger end of the egg-shaped 

 cavity is directed downwards and backwards. It 

 can hardly be said that there is any base or fundus 

 to the child's bladder. The viscus is situated mainly 

 in the abdomen, the pelvis being small and very 

 shallow. At birth the orifice of the urethra is on a 

 level with the upper edge of the symphysis. Although 

 the bladder projects so freely into the abdomen, its 

 anterior wall is still entirely uncovered by peritoneum. 

 On the posterior wall the serous membrane extends 

 lower down than in the adult, reaching the level of 

 the urethral orifice at the time of birth, and the level 

 of the prostate in young male children. The prostate 

 is exceedingly small in children. Thompson states that 

 at the age of seven years it only weighs thirty grains, 

 whereas in subjects between eighteen and twenty 

 it weighs two hundred and fifty grains. The bladder 

 wall in the child is so thin that in sounding for stone 

 it is said that a " click " may be elicited by striking 

 the pelvis through the parietes of the viscus. 



The prostate. The prostate is situated about 

 three-quarters of an inch below the symphysis pubis, 

 and rests upon the rectum in front of the bend between 

 the second and third segments of that viscus. It is, 

 therefore, placed within one andahalf to two inches from 

 the anus, and can be readily examined from the bowel. 



The secretion from the gland is discharged through 

 a number of long and very narrow ducts. In certain 

 forms of prostatic imtation, little white opaque threads, 

 very nnich like short pieces of cotton, are found in the 

 urine, and are actual casts of the prostatic ducts. 



The prostate is enveloped in a firm capsule 

 derived from the pelvic fascia, and it is to this fascia 

 that we look for an explanation of the course of 

 prostatic abscess. 



