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At the time the article was created Henry Knipe had no recorded disclosures.View Henry Knipe's current disclosures
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The ureter is 25-30 cm long and has three parts:
abdominal ureter: from the renal pelvis to the pelvic brim
pelvic ureter: from the pelvic brim to the bladder
intravesical or intramural ureter: within the bladder wall
The ureter begins its descent to the bladder by running along the medial aspect of the psoas muscle. Here, the ureter lies anteriorly and slightly medial to the tips of the L2-L5 transverse processes.
It enters the pelvis anteriorly to the sacroiliac joint at the bifurcation of the common iliac vessels (at the pelvic brim) and then courses anteriorly to the internal iliac artery down the lateral pelvic sidewall.
At the level of the ischial spine it turns forward and medially to enter the posterolateral wall of the bladder, where it runs an oblique 1-2 cm course, before opening into the bladder at the internal ureteric orifice 1,2.
The relations of the ureter are somewhat complex due to the differences between the left and right sides of the abdominal cavity and differences between male and female pelvic viscera.
Following the course of the ureter from superior to inferior 1,2:
posteriorly: sacroiliac joint, internal iliac artery
The ureter has a diameter of 3 mm 1 but there are three constrictions, which are the most common sites of renal calculus obstruction:
at the pelviureteric junction (PUJ) of the renal pelvis and the ureter
as the ureter enters the pelvis and crosses over the common iliac artery bifurcation
at the vesicoureteric junction (VUJ) as the ureter obliquely enters the bladder wall
venous drainage: via similarly named veins but is highly variable 1,2
abdominal ureter: aorto-caval and common iliac nodes
pelvic ureter: internal and external iliac nodes 1
The ureteric wall is composed of three layers (from outside to inside):
transitional cell epithelium 1
- 1. Butler P, Mitchell A, Healy JC. Applied Radiological Anatomy. Cambridge University Press. (2012) ISBN:0521766664. Read it at Google Books - Find it at Amazon
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- 3. Potenta S, D’Agostino R, Sternberg K, Tatsumi K, Perusse K. CT Urography for Evaluation of the Ureter. Radiographics. 2015;35(3):709-26. doi:10.1148/rg.2015140209 - Pubmed
- 4. Stephanie Ryan, Michelle McNicholas, Stephen J. Eustace. Anatomy for Diagnostic Imaging. (2011) Page 230. ISBN: 9780702029714 - Google Books