Ureteric injury

Question 1

How long are the ureters?

Answer 1

25-30cm

Question 2

list the 4 layers of the ureter

Answer 2

lumen
mucosa
adventitia
peritoneum

Question 3

what kind of epithelium makes up the lumen of the ureter

Answer 3

transitional epithelium

Question 4

what is the mucosal layer of the ureter made of?

Answer 4

muscular layer made of circular and spiral smooth muscle

Question 5

what is important about the adventitia layer of the ureter?

Answer 5

it is made up of an intercommunicating network of vessels

Question 6

How would you describe the ureter with regard to the peritoneum?

Answer 6

The ureter is completely retroperitoneal

Question 7

List 4 common sites of injury to the ureter

Answer 7

ligation of the IP ligament
ligation of the uterine artery
securing the vaginal vault angles
ligation of the paracervical tissue

Question 8

why is the ureter vulnerable to being damaged during ligation of the IP ligament?

Answer 8

the ureter enters the pelvis lateral to the IP ligament and then runs medial and inferior to the ovarian vessels

Question 9

Describe the course of the ureter once it enter the pelvic brim

Answer 9

• enters the pelvis crossing the division of the common iliac
• passes inferiorly and anteriorly along the pelvic side wall lateral to the peritoneum, medial to the branches of the internal iliac artery (obturator, inferior umbilical and superior vesicle arteries) and medial to the obturator nerve
• passes anteriorly and superiorly to the uterosacral ligaments, medial to pelvic sidewall (levator ani), lateral to the cervix and inferior to the uterine artery before entering the trigone of the bladder