Voelcker's Method of Extraperitonealization of the Urinary Bladder: Its Usefulness in Operations for Pathological Conditions of the Bladder and the Ureters

The peritoneum is very loosely fastened to the anterior and posterior walls of the bladder but it is firmly attached to the vertex of the bladder over an area about an inch in diameter, and this prevents the complete freeing of the bladder. When the bladder is filled with air or fluid, because of the loose attachment of the peritoneum to the anterior bladder wall, it is possible to expose a large part of this by pushing the peritoneum upward by blunt dissection. But in dealing with pathological conditions, such as tumours, of the vertex or the posterior and lateral walls of the bladder, where greater accessibility and exposure are necessary, this amount of extraperitoneal exposure of the bladder will not suffice.