The ureters are two muscular tubes, each about 25-30 cm long, that carry urine from the renal pelvis down to the bladder. They run on the front of the psoas muscle, cross the pelvic brim near the bifurcation of the common iliac artery, and enter the back of the bladder obliquely. Urine moves along them by waves of smooth muscle contraction, not by gravity alone.
| Location | Retroperitoneal, from the renal pelvis down along psoas major, across the pelvic brim and along the lateral pelvic wall to the posterolateral bladder |
|---|---|
| Parts |
|
| Nerve Supply | Renal, aortic and superior hypogastric plexuses (abdominal part); Inferior hypogastric plexus (pelvic part); Visceral pain afferents T11-L2 |
| Blood Supply | Ureteric branches of the renal artery; Gonadal artery branches; Abdominal aorta branches; Common iliac artery branches; Superior and inferior vesical arteries; Uterine artery branches |
| Venous drainage |
|
| Lymphatic drainage |
|
Carries urine from the kidney to the bladder by peristalsis and, at its oblique entry into the bladder wall, stops urine flowing back up.
Each ureter has three natural narrow points where stones commonly stick: the pelviureteric junction, where it crosses the pelvic brim, and where it enters the bladder wall. A stuck stone causes severe colicky loin-to-groin pain. Surgeons must protect the ureter during hysterectomy, because it passes just beneath the uterine artery ('water under the bridge') near the cervix.
Severe intermittent pain from a stone blocking the ureter, radiating from the flank to the groin and often with blood in the urine.
Accidental cutting, clamping or tying of the ureter during pelvic or abdominal surgery, most often hysterectomy, causing urine leak or obstruction.
Scarring that narrows the ureter after stones, surgery, radiation or infection, causing hydronephrosis.
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