Ureter surgery

2021-02-11 12:00 AM

There are 3 narrow places in the ureteral pelvic junction, where it intersects with the pelvic artery and the inner bladder, the ureter is divided into 2 segments.

General perception

The ureter is a fibrous tube located in the retroperitoneal connective organization from the renal pelvis to the bladder, 25 - 28 cm long, with an average diameter of 5mm. There are 3 narrow places in the renal pelvis - ureter junction, where the pelvic artery and the bladder wall are crossed. The ureter is divided into 2 segments.

Figure. Ureters

Abdominal segment

Going from the pelvic arc kidney pelvis. In the posterior ureter is involved with lumbar muscles and 3 transverse snouts of L3, L4, L5 lumbar vertebrae, intersecting with the femoral genital nerve. in addition, the left ureter also intersects with the common pelvic artery and the right ureter with the external pelvic artery. Anterior genital artery running diagonally across the anterior ureter, the right is also related to the lower duodenum, horizontal mesenteric root, left colon artery. In the right ureter is related to the inferior vena cava, left ureter with the abdominal aorta.

Pelvic segment

The pelvic segment is long, running from the pelvic arc to the ureter hole in the lumen of the bladder. The ureter runs along the side of the pelvis, next to the inner pelvic artery, and then turns inward to the back of the bladder. Here in women and men are related differently.

In men: before reaching the bladder, the ureter crosses behind the vas deferens, and then runs between the bladder and seminal vesicles to plug into the bladder.

In women: after leaving the pelvic wall, the ureter penetrates the base of the wide ligament, to the middle of the wide ligament the ureter crosses behind the uterine artery, where it crosses 0.8 to 1.5 mm from the cervix.

The two ureters are plugged in the wall of the bladder in a way that slips downwards inwards and out first and then opens into the bladder lumen with a small opening called the ureter opening.

Structure

The wall of the ureter is made up of 3 layers: the innermost layer is the continuous mucosa with the mucosa of the renal pelvis and the bladder mucosa. In the middle is the mechanical layer, the outer layer is the outer layer.