Volume 5: The Internal Organs and Reproductive System
The Abdominal Organs
Ureter in abdomen
Ureter in pelvis, male
Ureter entering bladder
Ureter in pelvis, female
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Now we'll return to the urinary system and follow the ureters down to the bladder. The ureter emerges from the hilum of the kidney and runs almost straight downward towards the pelvic brim, which is here. Behind the ureter is the psoas major muscle. The testicular vessels cross in front of the ureters in the male, the ovarian vessels do so in the female.
To follow the ureter as it passes into the pelvis, we'll continue the dissection down here. As the ureter runs over the pelvic brim and into the pelvis, it passes in front of the common iliac artery, just as it divides to become the internal and external iliac.
In both sexes the ureter passes downwards and forwards along the pelvic wall towards the bladder. It passes medial to the branches of the internal iliac vessels. In the male, the ductus deferens crosses the ureter medially.
To see the ureter entering the bladder we'll look at a specimen that's been divided along this line. Here's the divided pubic symphysis, here's the bladder, which we'll see shortly.
Here's the left ureter, entering the bladder behind and well to the side. Here passing just above it is the ductus deferens, which we'll see later in this tape.
Now we'll return to our view from in front, and look at the course of the ureter in the female. As in the previous dissection, we've removed the sigmoid colon and rectum. Their peritoneal attachments were here. Here are the ureters, crossing the pelvic brim.
This is the uterus, we'll pull it forward a little. Here are structures that we'll see in detail later in this tape: the broad ligament, the round ligament, the fallopian tube, and the ovary. This fold is the infundibulo-pelvic ligament. Here passing into it are the ovarian vessels. They're lateral to the ureter.
If we pull on the ureter we can see where it goes: it runs downwards and forwards around the pelvic wall, passing through the base of the broad ligament. To follow it we'll remove peritoneum here, and here, removing the underlying fat so that we make a window right through the broad ligament.
Here's the ureter behind the broad ligament, here it is in front, approaching the base of the bladder, which is here. The uterine blood vessels cross just above the ureter within the broad ligament.
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