Pelvic Ureters Anatomy
Each ureter enters the pelvis by crossing in front of the
common iliac vessels or the commencement of the external iliac vessels (Fig.
5.14). The ureter passes downwards and backwards before curving forwards to
reach the posterior surface of the bladder. The ureter crosses the medial
aspect of the obturator nerve and vessels and the superior vesical vessels
before running forwards along the levator ani muscle. The pelvic peritoneum
covers the medial aspect of the ureter and separates it from the rectum,
sigmoid colon or coils of ileum.
In the male, the ureter passes under the ductus deferens
and terminates near the seminal vesicle (Fig. 5.15). In the female, the ureter
descends on the lateral pelvic wall, outside the peritoneum but close to the
ovary as far as the ischial spine, where it turns medially across the pelvic
floor to reach the base (root) of the broad ligament. Here it crosses under the
uterine artery and passes close to the uterine cervix (Fig.
5.13). The ureter is vulnerable to damage during hysterectomy.
