URETER

• The ureters are a pair of narrow,thick walled muscular tubes which convey urine from kidneys to the urinary bladder

• Lie deep to peritoneum,closely applied to the posterior abdominal wall in the upper part,and to the

lateral pelvic part in the lower part

DIMENSIONSLength-25 cmDiameter-3mm

COURSEThe ureter begins within the renal

sinus as renal pelvis

The ureter passes downwards and slightly medially on the psoas muscle

enters the pelvis by crossing in front of termination of common iliac artery

After entering the pelvis it reaches the base of bladder

It enters bladder wall obliquely and open into lateral angle of trigone

3 parts:

PELVIS

ABDOMINAL

PELVIC

PELVISFunel shaped

dilatation at upper part

Formed by union of major calyces

Passes downwards and medially through hilum

Capacity – 5 to 7 ml

• Abdominal part

Passes downwards and medially by passing beneath the peritoneum

Enters pelvic cavity by crossing termination of common iliac artery

Posterior Relations

• Psoas major & fascia• Genitofemoral nerve• Tips of transverse

process

Anterior relations

Rt side –Parietal peritoneumRt gonadal vessels2nd & 3rd part of

duedenumRt colic & Ileocolic

vesselsRoot of mesentryTerminal part of ileum

Anterior relations

Lt side –Parietal peritoneumLt gonadal vesselsLt colic & sigmoid

vesselsApex of sigmoid

mesocolon

Pelvic part

First part – downwards beneath

peritoneum along greater sciatic notch & reaches ischial spine

• Second or oblique part - then forward and medially, through extra peritoneal tissue reaches superolateral angle of bladder 5cm from opposite ureter

Third part or Intravesical part –

Pierces musculature of bladder, undergoes oblique course downwards and medially thro bladder and opens into interior of bladder

• NORMAL CONSTRICTIONS

(1) At pelviureteral junction

(2) at brim of lesser pelvis

(3) at passage through bladderwall

Factors preventing reflux of urine

• Oblique direction of intravesical part of ureter• Trigonal muscle which by contraction

maintains the obliquity of ureter• Peristalsis of ureteral muscles at 2 to 5 times

per minute. Urine is collected in bladder in jets, not continually

BLOOD SUPPLYUpper part –renal arteryMiddle part-aortaPelvic part-vesical,middle rectal or uterine vessels

NERVE SUPPLYSympathetic- T10-L1Parasympathetic- S2-S4