Retropubic space

Retropubic space is a potential avascular space located between the pubic symphysis and the urinary bladder. The retropubic space is a preperitoneal space, located behind the transversalis fascia and in front of peritoneum .[1]

Retropubic space
Male pelvic organs seen from right side. (Retropubic space visible but not labeled.)
Vertical section of bladder, penis, and urethra. (Retropubic space visible but not labeled.)
Details
LocationPelvis, between the pubic symphysis and the urinary bladder.
FunctionAnatomical space
Identifiers
Latinspatium retropubicum
TA98A10.1.01.003
TA23822
FMA22060
Anatomical terminology

Other names for the retropubic space are "Cave of Retzius" or "Retzius' space", named after the Swedish anatomist Anders Retzius (1796-1860).

The space is a useful landmark in different gynecological and urological surgeries.

Structure

The space is located in the pelvic region and is bounded by the following structures:[1]

Function

The retropubic space is a potential space.

Compartmental Pressure

The retropubic space is directly adjacent to the abdominal cavity and is hence affected with change in intra-abdominal pressure, which in turn affects the physiology of urination and continence.[2] Normally, intra-abdominal pressure is between 5 and 7 mmHg, and can reach 10 to 15 mmHg chronically in certain cases, such as in pregnant or obese patients.[3] The pressure is strongly related to body mass index and a history of previous surgical procedures. This highly elevated pressure in obese and pregnant patients is sometimes referred to as chronic intra-abdominal hypertension.[4] This pressure is relayed to the adjacent retropubic compartment and can affect the structures within.

Clinical significance

The retropubic space is a surgical landmark that has surgical significance in several gynecological and urological procedures. Access to the space is achieved by separating the rectus abdominis muscle at the mid line, and bluntly dissecting the tissue in the direction of the symphysis pubis, until reaching the peritoneum.[1]

Examples of surgeries involving the retropubic space include:

See also

References
  1. "Volume 1, Chapter 86. Abdominal Operations for Urinary Stress Incontinence". www.glowm.com. Retrieved 2020-02-27.
  2. Cundiff, Geoffrey W (2004). "The Pathophysiology of Stress Urinary Incontinence: A Historical Perspective". Reviews in Urology. 6 (Suppl 3): S10–S18. ISSN 1523-6161. PMC 1472864. PMID 16985860.
  3. Sanchez, N. C.; Tenofsky, P. L.; Dort, J. M.; Shen, L. Y.; Helmer, S. D.; Smith, R. S. (March 2001). "What is normal intra-abdominal pressure?". The American Surgeon. 67 (3): 243–248. ISSN 0003-1348. PMID 11270882.
  4. Wilson, Alison; Longhi, James; Goldman, Charles; McNatt, Stephen (July 2010). "Intra-abdominal pressure and the morbidly obese patients: the effect of body mass index". The Journal of Trauma. 69 (1): 78–83. doi:10.1097/TA.0b013e3181e05a79. ISSN 1529-8809. PMID 20622581.
  5. F.C. Burkhard, J.L.H.R. Bosch, F. Cruz, G.E. Lemack, A.K. Nambiar, N. Thiruchelvam, A. Tubaro Guidelines Associates: D. Ambühl, D.A. Bedretdinova, F. Farag, R. Lombardo, M.P. Schneider. "EAU Guidelines on Urinary Incontinence in Adults" (PDF). European Association of Urology.CS1 maint: multiple names: authors list (link)
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