Approximately 2cm superior to the ischial spine, the ureters run underneath the uterine artery. during a hysterectomy, where the uterus and uterine artery are removed, the ureter is in danger of being accidentally damaged. the relationship between the two can be remembered using the phrase ‘water under the bridge’. The ureter lies above the lateral fornix of the vagina, below the uterine artery and vein as they pass across within the broad ligament.this relation of the.
1 13. synonyms: none. the ureters are bilateral, muscular, tubular structures, responsible for taking urine from one kidney to the urinary bladder for storage, prior to excretion. after blood has been filtered in the kidneys, the filtrate undergoes a series of reabsorptions and exudation throughout the length of the convoluted tubules. The ureters typically course inferior to the gonadal vessels (testicular or ovarian vessels). this surgically important relationship is best remembered by the phrase "water under the bridge," referring to the ureter's water content and uterine artery's horizontal orientation in this region (see image. female reproductive system blood supply). An in depth understanding of pelvic anatomy is a requirement of an advanced gynecologic surgeon, and remaining mindful of the location of the ureter is particularly important during dissection of the retroperitoneal space. typically, the ureter enters the pelvis over the common iliac artery and medial to its bifurcation at the pelvic brim. The uterine artery crosses the ureters anteriorly in the posterior uterine fold of peritoneum, like the ureters are “water under the uterine artery bridge”. the distance between the ureter and the cervix is about 1.5cm. the ureter then courses out to the ischial spines and continues medially onto the anterior vaginal fornix.
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