Topics

Topic

design image
Vesical venous plexus

The vesical venous plexus is a rich interconnected venous network that surrounds the urinary bladder in both males and females. It forms part of the pelvic venous plexuses, connecting with the prostatic venous plexus in males and the uterovaginal venous plexus in females. It provides major venous drainage of the bladder and serves as an important collateral pathway within the pelvis. Its communications with other venous plexuses make it a potential route for the spread of infection or malignancy.

Synonyms

  • Bladder venous plexus

  • Vesical plexus of veins

Location and Extent

  • Lies in the submucosa and muscular wall of the urinary bladder, extending into the perivesical fat

  • Distributed mainly at the base and inferior surface of the bladder

  • Connects anteriorly with veins of the anterior abdominal wall and posteriorly with pelvic venous networks

Relations

  • In males: Closely connected with the prostatic venous plexus and communicates with the internal vertebral venous plexus via the vesicoprostatic plexus

  • In females: Communicates with the uterovaginal venous plexus

  • Laterally: Related to the pelvic venous network and obturator vessels

  • Superiorly: Communicates with vesical branches of the superior vesical veins

Function

  • Provides venous drainage of the urinary bladder

  • Acts as a venous communication network with adjacent pelvic organs (uterus, prostate, vagina, rectum)

  • Functions as a collateral venous pathway within the pelvis

  • Contributes to venous return without valves, allowing bidirectional flow

Clinical Significance

  • May be a route for spread of bladder carcinoma to pelvic and vertebral venous systems

  • Important in prostate cancer spread (via vesicoprostatic plexus to spine)

  • Can be involved in pelvic venous congestion or varicosities

  • Susceptible to injury during pelvic surgery (e.g., prostatectomy, hysterectomy)

  • May mimic or obscure pelvic pathology on imaging when engorged

MRI Appearance

T1-weighted images:

  • Normal veins appear as flow voids (dark signal channels)

  • Thrombosis or slow flow may appear as intermediate-to-bright intraluminal signal

  • Fat surrounding the plexus appears bright

T2-weighted images:

  • Veins show flow voids in normal conditions

  • Dilated or thrombosed veins may appear as bright tubular or rounded structures

  • Fluid-filled venous channels can appear hyperintense

STIR (Short Tau Inversion Recovery):

  • Normal venous channels appear dark

  • Surrounding fat is suppressed (dark), highlighting any bright hyperintense thrombus, varix, or edema

T1 Fat-Sat Post-Contrast:

  • Veins enhance strongly and homogeneously with contrast

  • Thrombosed veins show lack of enhancement with possible peripheral rim enhancement

  • Enhancing venous collaterals may be prominent in pelvic congestion syndrome

CT Appearance

Non-Contrast CT:

  • Vesical venous plexus not easily visible unless dilated

  • Appears as soft tissue–density tubular channels in perivesical fat

  • Thrombus may appear as hyperdense filling material within a vein

Post-Contrast CT (venous phase):

  • Veins enhance uniformly with contrast, outlining the venous network around the bladder

  • Engorged plexus appears as prominent enhancing tubular channels

  • Thrombosed veins fail to enhance, appearing as filling defects within enhancing venous channels

MRI image

Vesical venous plexus mri axial anatomy image-img-00000-00000

MRI image

Vesical venous plexus mri axial anatomy image-img-00000-00000_00001

MRI image

Vesical venous plexus mri sag anatomy image male

CT image

Vesical venous plexus CT axial anatomy male

MRI image

Vesical venous plexus CT axial anatomy female

CT images

Vesical venous plexus female ct