Prevesical Space, Cooper’s Ligament, Paravesical Space, Arcus Tendineus Fascia Pelvis

Abstract

We perform the peritoneal incision with scissors and a cleavage in the loose tissue. When we are in the correct plane, the dissection is easy and bloodless. The prevesical space or Retzius space is an avascular extraperitoneal space between the pubic symphysis ventrally and the pubic ramus laterally, and the sidewalls are composed of pubic bone and obturator internus muscle. The urinary bladder is seen dorsally. The floor of the Retzius space is formed by the anterior vagina and endopelvic fascia and pubocervical fascia, stretching along the symphysis and inserting at the level of the arcus tendineus fascia pelvis (ATFP). Lateral to the urethra are the pubo-urethral ligaments. At the floor of the prevesical space, the pubocervical fascia inserts into the ATFP. Above it, the arcus tendineus levator ani (ATLA) is the origin of the levator ani muscles.