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  1. Ureters are a pair of thick walled tubes which convey urine from kidneys to urinary bladder. It is a retroperitoneal structure. Each ureter is 25 cm (10 inches) long and is divided into abdominal and pelvic part, i.e. upper half(5 inches) lies in abdomen and lower half(5 inches) in pelvic. The ureter begins within the renal sinuses funnel shaped dilation, called renal pelvis. Gradually it narrows till the lower end of kidney where it becomes the ureter proper. Ureter emerges from the hilum and runs vertically downward retroperitoneal (behind parietal peritoneum) on the psoas muscle. It enters the true (lesser) pelvis by crossing anterior to the bifurcation of common iliac artery and origin of external iliac vessels, in front of sacroiliac (SI) joint. Opposite the ischial spine it turns anteromedial to reach the bladder base at an angle (not straight). Ureter opens into lateral angle of trigone. Ureteric openings lie 5 cm apart in distended bladder and only 2.5 cm apart in bladder.
  2. Ureter measures about 3 mm in diameter, but is constricted at five places :- (i) pelviureteric junction; (ii) brim of lesser pelvis (at the level of bifurcation of common iliac artery and crossing of external iliac artery; (iii) point of crossing of ureter by ductus deferens or broad Iigament; (iv) entry in bladder wall(this vesicourethral junction is the narrowest part of ureter; and (v) opening in lateral angle of trigone,
  3. Ureter is lined by transitional epithelium.

Important relations of abdominal part


Relations of abdominal part of ureter are:-

  1. Anterior relations
    1. Right ureter: - Duodenum (3rd part), peritoneum, right colic vessels, iIiocolic vessels gonadal vessels, root of the mesentery, and ileum (terminal part).
    2. Left ureter:- Peritoneum, gonadal artery, left colic vessels, sigmoid colon and sigmoid mesocolon.
  2. Posterior relations Ureter lies on psoas major, transverse process (tips), and genitofemoral nerve.
  3. Medially
    1. Right ureter:- IVC
    2. Left ureter:- Left gonadal vein and inferior mesenteric vein.

Important relations of pelvic part

  1. Relations of pelvic part of ureter are :-
    1. Posterior relations
      Posteriorly ureter is related to internal iliac artery, initiation of anterior trunk of internal iliac artery, internal iliac vein, lumbosacral trunk and SI joint.
    2. Lateral relations
      Laterally ureter is related to obturator fascia, superior vesical artery, obturator vessels and nerve, inferior vesical vein, and middle rectal artery.
  2. In its forward course, relations are :-
    1. In males
      Ductus deferenscrosses ureter superiorly from lateral to medial.
      Seminal vesicle lies behind and below the ureter.
      Vesical vein surrounds the terminal part of ureter.
    2. In females
      Ureter lies in lower and medial part of broad ligament.
      Uterine artery crosses ureter superiorly from lateral to medial.
      Ureter lies 2 cm lateral to supravaginal portion of cervix.
      Terminal part of ureter lies anterior to vagina.

Blood supply

  1. Upper part: - It is mainly supplied by renal artery. It may also receive branches from gonadalor colic vessels.
  2. Middle part: - It receives branches from the aorta. It may also receive branches from gonadalor iliac vessels.
  3. Lower part (pelvic part):- It is supplied by branches from the vesical, middle rectal or uterine vessels.

Nerve supply


Ureter is supplied by sympathetic from T10 - L. segmentand parasympathetic from S2-S4 nerves. They reach ureter through the renal, aortic and hypogastric plexuses.

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