Page 131 - Clinical Anatomy

ECA2 7/18/06 6:43 PM Page 116

116 The abdomen and pelvis

epithelium as far as the entry of the ejaculatory ducts in the prostatic urethra.
This is conveniently termed the uroepithelium since it has a uniform appear-
ance and is subject to the same pathological processes — for example, the
development of papillomata. The remainder of the urethra has a columnar
lining except at its termination, where the epithelium becomes squamous.

Radiology of the urinary tract

The renal contours can often be identified on a soft tissue radiograph of the
abdomen. Intravenous injection of iodine-containing compounds excreted
by the kidney will produce an outline of the calyces and the ureter (intra-
venous urogram). When the injection medium enters the bladder, a cys-
togram is obtained (Fig. 84).
Further information can be obtained by passing a catheter up the ureter
through a cystoscope and injecting radio-opaque fluid to fill the pelvis and
calyx system (retrograde pyelogram). Similarly, injection of such fluid into
the urethra or bladder may be used for the radiographic study of these
viscera.
The kidneys are beautifully delineated in transverse section on CT
scans (Figs. 83b, 111 and 112).

The male genital organs

The prostate (Fig. 87)
This is a pyramidal-shaped, fibromuscular and glandular organ, 1.25in
(3cm) long, which surrounds the prostatic urethra. It resembles the size and
shape of a chestnut.

Relations (Fig. 62)
•◊◊Superiorly—the prostate is continuous with the neck of the bladder. The
urethra enters the upper aspect of the prostate near it anterior border.
•◊◊Inferiorly—the apex of the prostate rests on the external sphincter of the
bladder which lies within the deep perineal pouch.
•◊◊Anteriorly— lies the pubic symphysis separated by the extraperitoneal
fat of the cave of Retzius or retropubic space. Close against the prostate in this
space lies the prostatic plexus of veins. Near the apex of the prostate, the
puboprostatic ligament (a condensation of fibrous tissue) passes forward to
the pubis.
•◊◊Posteriorly—lies the rectum separated by the fascia of Denonvilliers.
•◊◊Laterally—lies levator ani.
The ejaculatory ducts enter the upper posterior part of the gland to
open into the urethra at the colliculus seminalis or verumontanum, one on
either side of the prostatic utricle, dividing off a median prostatic lobe lying