描述

The pelvic part (pars pelvina) runs at first downward on the lateral wall of the pelvic cavity, along the anterior border of the greater sciatic notch and under cover of the peritoneum.

It lies in front of the hypogastric artery medial to the obturator nerve and the umbilical, obturator, inferior vesical, and middle hemorrhoidal arteries.

Opposite the lower part of the greater sciatic foramen it inclines medialward, and reaches the lateral angle of the bladder, where it is situated in front of the upper end of the seminal vesicle and at a distance of about 5 cm. from the opposite ureter; here the ductus deferens crosses to its medial side, and the vesical veins surround it.

Finally, the ureters run obliquely for about 2 cm. through the wall of the bladder (the intramural part of the ureter) and open by slit-like apertures into the cavity of the viscus at the lateral angles of the trigone. When the bladder is distended the openings of the ureters are about 5 cm. apart, but when it is empty and contracted the distance between them is diminished by one-half. Owing to their oblique course through the coats of the bladder, the upper and lower walls of the terminal portions of the ureters become closely applied to each other when the viscus is distended, and, acting as valves, prevent regurgitation of urine from the bladder.

In the female, the ureter forms, as it lies in relation to the wall of the pelvis, the posterior boundary of a shallow depression named the ovarian fossa, in which the ovary is situated. It then runs medialward and forward on the lateral aspect of the cervix uteri and upper part of the vagina to reach the fundus of the bladder. In this part of its course it is accompanied for about 2.5 cm. by the uterine artery, which then crosses in front of the ureter and ascends between the two layers of the broad ligament. The ureter is distant about 2 cm. from the side of the cervix of the uterus. The ureter is sometimes duplicated on one or both sides, and the two tubes may remain distinct as far as the fundus of the bladder. On rare occasions they open separately into the bladder cavity.


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