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Palpation of urinary bladder

Normally the urinary bladder is not palpable. When there is retention of urine, a smooth firm regular oval shaped swelling will be palpated in the suprapubic region and its dome may sometimes reach as high as the umbilicus. The lateral and upper borders can be readily made out but it is not possible to feel its lower border In females.
However, the palpable bladder has to be differentiated from a gravid uterus, fibroid uterus and an ovarian cyst.
Gravid uterus: It is firmer, mobile side to side and vaginal signs are present.
Fibroid uterus: It is felt as a bosselated, firm swelling with different vaginal signs.
Ovarian cyst: It is eccentrically placed (left or right side).