Overview
The ureters are paired muscular ducts with narrow lumina that carry urine from the kidneys to the bladder.
An understanding of the anatomic relations of the ureters is critical to the practice of urology, as well as to the disciplines of gynecologic, vascular, and general surgery. The ureter serves as a critical landmark and is intimately involved with other vessels and organs, making accidental ureteral injury a dreaded consequence of surgery (see the image below). Knowledge of the microscopic anatomy and vascular supply of the ureter are essential during manipulation of the ureter.
Relation of the uterine artery to the ureter during hysterectomy.
The ureter is subject to natural variation such as duplication. Pathologic variants of the ureter are also prevalent and can manifest as urinary obstruction, renal failure, and infection.
Increasingly, aberrant ureteral anatomy can be identified on antenatal ultrasonography, enabling early medical and surgical intervention.