The Transverse Vesical Fold is a Nontransient and Vascularized Structure

Laparoscopy provides a dynamic perspective that can alter conceptions of anatomical structures in the peritoneal cavity. The transverse vesical fold ( plica vesicalis transversa ) named by Waldeyer is a salient peritoneal laparoscopic feature of the anterior pelvic cavity and stretches between the lateral side of the urinary bladder to the pelvic wall, subdividing the paravesical fossa. However, it is rarely clearly visualized in the embalmed cadaver and is not figured in most current anatomical atlases. Early editions of Gray's Anatomy state that the transverse vesical fold disappears when the bladder is full. We report here that this is not the case. Although showing individual variability, the transverse vesical fold in the living patient is a nontransient structure and in fact becomes more prominent as the bladder is stretched during filling. Cadaveric dissection of the transverse vesical fold demonstrates that this structure is a vascularized peritoneal fold usually containing one or more branches of the superior vesical artery. We suggest that Gray's error refers to the shallow groove on the posterosuperior border of the bladder connecting the medial ends of the two transverse vesical folds. Waldeyer figured this area but clearly labelled it as the peritoneal “roof” (“obtecta”) of the bladder. We propose that this peritoneal groove be termed the “obtectal groove of the bladder,” and suggest that it, not the transverse vesical ligament, tends to disappear with a filled bladder.