Postvesical nodes

At a glance

English

Postvesical nodes

Latin (TA2)

Nodi postvesicales

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the postvesical nodes

Lymph from the bladder is collected by a scattered set of small nodes in the connective tissue around it, together called the paravesical nodes. They are named by where they lie: prevesical nodes in front, lateral vesical nodes at the sides along the obliterated umbilical artery, and postvesical nodes behind. The postvesical nodes are small and inconstant, and many people have only one or two.

They sit in the fat on the posterior surface and base of the bladder, below the peritoneum that dips behind it, and close to the points where the ureters enter the bladder wall. The vesical venous plexus surrounds them, and the rectum lies further back, beyond the fascia that separates the bladder from it.

Lymph reaches these nodes from the base and posterior wall of the bladder, including the trigone, the smooth triangular area between the ureteric openings and the start of the urethra. From here, lymph passes mainly to the external iliac nodes, in particular the medial chain, and partly to the internal iliac nodes, before rising to the common iliac nodes.

Cancer of the bladder often arises at the base and trigone, and the small nodes immediately around the bladder can be the first to hold tumour cells. They are removed with the bladder and its surrounding fat at cystectomy, and their state, together with that of the pelvic wall nodes, helps set the stage of the disease and the need for further treatment.

Course and drainage

Begins at

Afferent vessels from the base and posterior wall of the urinary bladder, including the trigone.

Drains into

Efferent vessels pass to the external iliac nodes, mainly the medial chain, and to the internal iliac nodes.

Drains

Filters lymph from the back and base of the bladder. They may be the first nodes to receive bladder cancer and are removed with the bladder at cystectomy.