膀胱内の

関: intravesically

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2012/11/12 01:42:04」(JST)

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For other uses, see bladder (disambiguation).

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow^[1] muscular, and distensible (or elastic) organ, the bladder sits on the pelvic floor. Urine enters the bladder via the ureters and exits via the urethra.

Bladders occur throughout much of the animal kingdom, but are very diverse in form and in some cases are not homologous with the urinary bladder in humans.

The human urinary bladder is derived in embryo from the urogenital sinus and, it is initially continuous with the allantois. In males, the base of the bladder lies between the rectum and the pubic symphysis. It is superior to the prostate, and separated from the rectum by the rectovesical excavation. In females, the bladder sits inferior to the uterus and anterior to the vagina; thus, its maximum capacity is lower than in males. It is separated from the uterus by the vesicouterine excavation. In infants and young children, the urinary bladder is in the abdomen even when empty.^[2]

Detrusor muscle

The detrusor muscle is a layer of the urinary bladder wall made of smooth muscle fibers arranged in spiral, longitudinal, and circular bundles. When the bladder is stretched, this signals the parasympathetic nervous system to contract the detrusor muscle. This encourages the bladder to expel urine through the urethra.

For the urine to exit the bladder, both the autonomically controlled internal sphincter and the voluntarily controlled external sphincter must be opened. Problems with these muscles can lead to incontinence.

The urinary bladder usually holds 300-350 ml of urine. As urine accumulates, the rugae flatten and the wall of the bladder thins as it stretches, allowing the bladder to store larger amounts of urine without a significant rise in internal pressure.^[3]

Since the urinary bladder has a transitional epithelium, it does not produce mucus.^[4]

Fundus

Bladder

The fundus of the bladder is the base of the bladder, formed by the posterior wall. It is lymphatically drained by the external iliac lymph nodes. The peritoneum lies superior to the fundus.

Urination frequency

Males with an enlarged prostate urinate more frequently. One definition of Overactive bladder is when a person urinates more than eight times per day, though there can be other causes of urination frequency.^{[citation needed]}

Innervation

The bladder receives motor innervation from both sympathetic fibers, most of which arise from the hypogastric plexuses and nerves, and parasympathetic fibers, which come from the pelvic splanchnic nerves and the inferior hypogastric plexus.^[5]

Sensation from the bladder is transmitted to the central nervous system (CNS) via general visceral afferent fibers (GVA). GVA fibers on the superior surface follow the course of the sympathetic efferent nerves back to the CNS, while GVA fibers on the inferior portion of the bladder follow the course of the parasympathetic efferents.^[5]

Disorders

Main article: Urinary bladder disease

A diverticulum of the bladder

Disorders of or related to the bladder include:

Bladder cancer
Bladder exstrophy
Bladder infection
Bladder spasm
Bladder sphincter dyssynergia, a condition in which the sufferer cannot coordinate relaxation of the urethra sphincter with the contraction of the bladder muscles
Bladder stones
Cystitis
Hematuria, or presence of blood in the urine, is a reason to seek medical attention without delay, as it is a symptom of bladder cancer as well as bladder and kidney stones
Interstitial Cystitis
Overactive bladder, a condition that affects a large number of people
Urinary incontinence
Urinary retention

References

^ Howard A. Werman, Keith J. Karren.
^ Moore, Keith L.; Dalley, Arthur F (2006). Clinically Oriented Anatomy (5th ed.). Lippincott Williams & Wilkins.
^ Marieb, Mallatt. "23". Human Anatomy (5th ed.). Pearson International. p. 700.
^ Chin T, Liu , Tsai H, Wei C (September 2007). "Vaginal reconstruction using urinary bladder flap in a patient with cloacal malformation". Journal of Pediatric Surgery 42 (9): 1612–5. doi:10.1016/j.jpedsurg.2007.04.040. PMID 17848259.
^ ^a ^b Moore, Keith; Anne Agur (2007). Essential Clinical Anatomy, Third Edition. Lippincott Williams & Wilkins. pp. 227–228. ISBN 0-7817-6274-X.

External links

Wikimedia Commons has media related to: Urinary bladder

Histology at KUMC epithel-epith09 "Urinary Bladder"
Organology at UC Davis Urinary/mammal/bladder/bladder1 - "Mammal, bladder (LM, Medium)"
Virtual Slidebox at Univ. Iowa Slide 445
SUNY Labs 43:07-0100 - "The Female Pelvis: The Urinary bladder"
SUNY Labs 44:04-0103 - "The Male Pelvis: The Urinary bladder"

Additional images

Structure of the penis
Organs of the female reproductive system.
Coronal section of pelvis, showing arrangement of fasciæ. Viewed from behind.
Dissection of side wall of pelvis showing sacral and pudendal plexuses. (Bladder visible at lower left.) |
The peritoneum of the male pelvis.
Median sagitta section of male pelvis.
Male pelvic organs seen from right side.
Median sagittal section of female pelvis.
The interior of bladder.
Vertical section of bladder wall.
Fundus of the bladder with the vesiculæ seminales.
Vertical section of bladder, penis, and urethra.
Female pelvis and its contents, seen from above and in front.
Topography of thoracic and abdominal viscera.
The bladder can be seen highlighted in yellow in the illustration.
Layers of the urinary bladder wall and cross section of the detrusor muscle.
Urinary bladder (black butterfly-like shape) and hyperplastic prostate (BPH) visualized by Medical ultrasonography technique.
Urinary bladder

UpToDate Contents

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1. 間質性膀胱炎／膀胱痛症候群のマネージメント management of interstitial cystitis bladder pain syndrome
2. Treatment of primary non-muscle invasive urothelial bladder cancer
3. 尿路上皮膀胱癌の初期アプローチおよびマネージメントの概要 overview of the initial approach and management of urothelial bladder cancer
4. Management of recurrent or persistent non-muscle invasive bladder cancer
5. Patient education: Bladder cancer treatment; non-muscle invasive (superficial) cancer (Beyond the Basics)

English Journal

Ureteroneocystostomy in primary vesicoureteral reflux: critical retrospective analysis of factors affecting the postoperative urinary tract infection rates.

Dogan HS, Bozaci AC, Ozdemir B, Tonyali S, Tekgul S.
International braz j urol : official journal of the Brazilian Society of Urology.Int Braz J Urol.2014 Dec 3. doi: . [Epub ahead of print]
Introduction: To determine the parameters affecting the outcome of ureteroneocystostomy (UNC) procedure for vesicoureteral reflux (VUR). Materials and Methods: Data of 398 patients who underwent UNC procedure from 2001 to 2012 were analyzed retrospectively. Different UNC techniques were used accordi
PMID 24893914

Advances in intravesical therapy for the treatment of non-muscle invasive bladder cancer (Review).

Weintraub MD, Li QQ, Agarwal PK.
Molecular and clinical oncology.Mol Clin Oncol.2014 Sep;2(5):656-660. Epub 2014 Jun 12.
The knowledge of tumor biology and the biomechanical properties of the urothelium have led to significant advances in the development of intravesical therapy for the treatment of non-muscle invasive bladder cancer (NMIBC). Targeted therapy improves the efficacy and decreases the side effects of anti
PMID 25054027

Cationic core-shell nanoparticles for intravesical chemotherapy in tumor-induced rat model: Safety and efficacy.

Erdogar N1, Iskit AB2, Eroglu H3, Sargon MF4, Mungan NA5, Bilensoy E6.
International journal of pharmaceutics.Int J Pharm.2014 Aug 25;471(1-2):1-9. doi: 10.1016/j.ijpharm.2014.05.014. Epub 2014 May 13.
Mitomycin C (MMC) has shown potent efficacy against a wide spectrum of cancers and is clinical first choice in superficial bladder tumors. However, intravesical chemotherapy with MMC has been ineffective due to periodical discharge of the bladder and instability of this drug in acidic pH, both resul
PMID 24836669

Japanese Journal

上部尿路癌術後の膀胱内再発予防 (特集ここが知りたい! 筋層非浸潤性膀胱癌 : エキスパートが答える日常診療の疑問点)

臨床泌尿器科 = Japanese journal of clinical urology 70(2), 178-181, 2016-02
NAID 40020731519

BCG膀胱内注入療法後,結核性前立腺膿瘍を来たした1例

泌尿器科紀要 = Acta urologica Japonica 61(11), 465-468, 2015-11
NAID 120005679847

尿路上皮癌BCG膀胱内注入療法によるReiter症候群 : 自験例の6症例を加えた本邦過去13年間の症例報告のまとめ

日本泌尿器科学会雑誌 = The Japanese journal of urology 106(4), 238-242, 2015-10
NAID 40020624917

「膀胱内」

Urinary bladder
	1. Human urinary system: 2. Kidney, 3. Renal pelvis, 4. Ureter, 5. Urinary bladder, 6. Urethra. (Left side with frontal section); 7. Adrenal gland; Vessels: 8. Renal artery and vein, 9. Inferior vena cava, 10. Abdominal aorta, 11. Common iliac artery and vein; With transparency: 12. Liver, 13. Large intestine, 14. Pelvis
	Male Bladder Makeup
Latin	vesica urinaria
Gray's	subject #28 1227
Artery	Superior vesical artery; Inferior vesical artery; Umbilical artery; Vaginal artery
Vein	Vesical venous plexus
Nerve	Vesical nervous plexus
Lymph	external iliac lymph nodes, internal iliac lymph nodes
Precursor	urogenital sinus
MeSH	Bladder
Dorlands/Elsevier	Urinary bladder

　　[★]

英: intravesical、intravesically

「intravesically」

　　[★]

膀胱内に

関: intravesical

[1] Howard A. Werman, Keith J. Karren.

[2] Moore, Keith L.; Dalley, Arthur F (2006). Clinically Oriented Anatomy (5th ed.). Lippincott Williams & Wilkins.

[3] Marieb, Mallatt. "23". Human Anatomy (5th ed.). Pearson International. p. 700.

[4] Chin T, Liu , Tsai H, Wei C (September 2007). "Vaginal reconstruction using urinary bladder flap in a patient with cloacal malformation". Journal of Pediatric Surgery 42 (9): 1612–5. doi:10.1016/j.jpedsurg.2007.04.040. PMID 17848259.

[Moore227-5] Moore, Keith; Anne Agur (2007). Essential Clinical Anatomy, Third Edition. Lippincott Williams & Wilkins. pp. 227–228. ISBN 0-7817-6274-X.

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