Space of Retzius

spatium retropubicum Retzii

The space of Retzius (retropubic space) is the extraperitoneal potential space between the pubic symphysis and the anterior bladder wall, extending laterally to the lateral pelvic walls. It is bounded anteriorly by the pubic symphysis and the transversalis fascia, posteriorly by the anterior bladder wall, and laterally by the obturator muscles and fascia. It contains the prevesical fat, the pubovesical ligaments, the dorsal venous complex in males, and the space of access for retropubic procedures.

Anatomical Data

Boundaries & Contents

Location	Front of the pelvis, behind the pubic symphysis and in front of the bladder, outside the peritoneum
Boundaries	Pubic symphysis and bodies of the pubic bones (front) Anterior bladder wall and umbilicovesical fascia (back) Obturator internus fascia and pelvic side walls (sides) Pubovesical or puboprostatic ligaments and pelvic floor fascia (floor) Extends upward behind the rectus sheath toward the umbilicus
Contents	Fat and loose connective tissue Retropubic venous plexus (dorsal venous complex in males) Pubovesical or puboprostatic ligaments Accessory obturator vessels on the side wall in some people

Biomechanics

Function & Actions

Lets the bladder fill and expand upward behind the abdominal wall. It is the surgical route to the bladder neck and prostate without opening the peritoneum.

Clinical Relevance

Clinical Notes

The space of Retzius is the surgical space for retropubic prostatectomy, bladder neck suspension (Burch colposuspension), tension-free vaginal tape (TVT) for stress incontinence, and TEP laparoscopic inguinal hernia repair. In radical prostatectomy, control of the dorsal venous complex (Santorini plexus) in the space of Retzius is the critical haemostatic step before the prostate can be freed from the urethra. Haematoma in the space of Retzius from pelvic fracture or surgical complication causes bladder displacement and urinary retention.

Pathology

Common Injuries & Conditions

Haematoma in Space of Retzius After Pelvic Fracture

Anterior pelvic ring fracture tears the prevesical veins and produces a haematoma expanding within the space of Retzius that displaces the bladder posteriorly on CT causing obstructive uropathy, managed by suprapubic catheter and observation as most pelvic haematomas resolve with non-operative management.

Explore

More in Pelvis & Hip

Browse all of Pelvis & Hip →