Vesical Venous Plexus - Structure, Location, Function

The vesical venous plexus is a complex network of interconnected veins located around the urinary bladder. It plays a central role in draining venous blood from the bladder and surrounding pelvic structures. The plexus is especially prominent in males, where it communicates with the prostatic and rectal venous plexuses, and in females, where it communicates with the uterovaginal plexus. Due to its connections with systemic and portal systems, the vesical venous plexus is also a potential route for the spread of pelvic infections or malignancies.

Structure

The vesical venous plexus consists of an intricate web of thin-walled, valveless veins. These veins form an extensive anastomotic network around the inferolateral surfaces and base of the urinary bladder. The plexus surrounds the bladder's neck and expands into surrounding connective tissue within the endopelvic fascia.

Components: Numerous small veins interconnected around the bladder wall
Valves: Largely absent, allowing bidirectional flow
Communications: Connected to prostatic (in males), uterovaginal (in females), rectal, and pudendal venous plexuses

Location

The vesical venous plexus lies in the perivesical fat surrounding the base and inferolateral surfaces of the urinary bladder. It is situated within the pelvic cavity and is embedded in the loose connective tissue of the endopelvic fascia.

Direction	Related Structure
Anterior	Pubic symphysis (via retropubic space)
Posterior (male)	Prostatic venous plexus
Posterior (female)	Uterovaginal venous plexus
Lateral	Pelvic walls and obturator internus muscle
Inferior	Drains toward internal iliac veins

Function

Venous Drainage: Drains deoxygenated blood from the urinary bladder into the internal iliac vein via vesical veins
Pressure Regulation: Assists in managing pressure changes during bladder filling and voiding
Collateral Circulation: Serves as an anastomotic bridge between pelvic venous networks, including prostatic/uterovaginal and rectal plexuses

Drainage Pathway

Vesical venous plexus → Vesical veins → Internal iliac vein → Common iliac vein → Inferior vena cava

Lymphatic Drainage

External and internal iliac lymph nodes

Clinical Significance

Bladder Cancer Spread: The valveless nature permits retrograde flow and possible metastatic spread
Venous Congestion: May occur with pelvic masses or venous obstruction
Surgical Bleeding Risk: Injury to the plexus during pelvic surgery (e.g., prostatectomy or cystectomy) can cause significant bleeding