title: Variations of urinary bladder and the urogenital fatty fascial compartment with different filling of the bladder are notable factors relevant to hernia repair-related bladder injury.
abstract: The present study investigated bladder and urogenital fatty fascial compartment (UFFC) variations during bladder filling in an attempt to identify other possible causes of hernia repair-related bladder injury besides mesh migration. The study included 30 patients scheduled for abdominal  computed tomography (CT) scan for nonhernia diseases. Sixty-four-slice CT scan was performed immediately after urination and no more than 30 minutes later. Three-dimensional images were constructed by two independent experienced readers. The empty bladder was triangular in shape, narrow in  the front and broad in the rear. Its vertex deviated from midline of the abdominal wall in 11 cases (36.7%).With normal filling, it appeared as an irregular oval shape. Only two cases (6.7%) of empty bladder extended inside Hesselbach's triangle. However, this area was occupied to some  extent in all cases during bladder filling (P = 0.003). The UFFC formed a molar-like structure in cross-section. In three dimensions, it appeared as an inverted V-shaped structure from the front. In the lateral view it appeared as a spoon that contained the bladder. UFFC volume increased  from 61.85 ± 6.23 to 139.23 ± 5.29 cm(3) with bladder filling (P < 0.0001). The UFFC can be clearly identified by CT scanning or three-dimensional reconstruction. The considerable spatial variation of the UFFC and movement and deformation of the mesh within  this area may be related to bladder injury.
authors: Department of Surgical Disciplines, South China Training Center for Hernia Therapy, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
authors: Zhi-Peng
authors: ZP
authors: Jiang
authors: Dong-Ye
authors: DY
authors: Wang
authors: Dong-Ming
authors: DM
authors: Lai
authors: Quan-Bo
authors: QB
authors: Zhou
authors: Yu-Chao
authors: YC
authors: Zhang
authors: Bin
authors: B
authors: Yang
authors: Shuang
authors: S
authors: Chen
mesh_terms: D000328:Adult; D003287:Contrast Media; D005205:Fascia / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000502:physiology*; D005260:Female; D059685:Herniorrhaphy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D007431:Intraoperative Complications / Q000209:etiology* / Q000517:prevention & control; D007479:Iopamidol; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology* / Q000517:prevention & control; D013526:Surgical Mesh / Q000009:adverse effects; D001743:Urinary Bladder / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000293:injuries / Q000502:physiology*
chemical_list: D003287:Contrast Media; D007479:Iopamidol