The retropubic space (space of Retzius) is the prevesical extraperitoneal space between the pubic symphysis and the anterior bladder wall, containing loose areolar tissue, the paravesical venous plexus, and lymphatics. This is the space developed in retropubic prostatectomy and Burch colposuspension.
The retropubic space is the operative field for open radical prostatectomy (Walsh technique), where the endopelvic fascia and puboprostatic ligaments are divided to mobilise the prostate. In laparoscopic and robotic prostatectomy, this space is developed extraperitoneally (TEP approach) or transperitoneally. Haematoma in this space causes paravesical compression, urinary retention, and pelvic pain in post-operative patients.
Blood accumulation in the space of Retzius after pelvic or prostate surgery producing bladder displacement, urinary obstruction, and pelvic pain, managed by observation or surgical evacuation for expanding haematoma.
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