Prevesical nodes

At a glance

English

Prevesical nodes

Latin (TA2)

Nodi prevesicales

System

Lymphatic

Region

Trunk

Side

Single, on the midline

About the prevesical nodes

The prevesical nodes are one subgroup of the paravesical nodes, the small nodes that cluster in the connective tissue around the bladder. The others are the lateral vesical nodes at the sides and the postvesical nodes behind. Prevesical nodes are few, small and not always present.

They lie in the retropubic space, also called the space of Retzius, a fat-filled gap between the anterior surface of the bladder and the pubic bones and symphysis. The space is bounded above by the transversalis fascia of the lower abdominal wall and is crossed by the median umbilical ligament, the remnant of the urachus running up from the apex of the bladder. The vesical venous plexus lies around the bladder neck below.

Lymph enters the nodes from the anterior and superior walls of the bladder and from the bladder neck. It then passes to the external iliac nodes, mainly the medial chain, and partly to the internal iliac nodes, before rising to the common iliac nodes.

Bladder cancers on the front wall or dome may spread first to these nodes. They are taken with the surrounding fat during cystectomy. The retropubic space they occupy is also the route surgeons use to reach the bladder neck without opening the peritoneum, and blood or urine leaking from an injured bladder collects in it, sometimes carrying infection towards these nodes.

Course and drainage

Begins at

Afferent vessels from the anterior and superior walls and the neck of the urinary bladder.

Drains into

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

Drains

Filters lymph from the front and dome of the bladder. A possible first site of spread for bladder cancer on the anterior wall, removed with the bladder at cystectomy.