Urinary Tract

Question 1

What is the average length of the ureter?

Answer 1

25-30cm

Question 2

What is the relationship of the ureter to the renal artery?

Answer 2

The ureter begins traversing POSTERIORLY to the renal artery

Question 3

What is the relationship of the ureter to the psoas muscle?

Answer 3

The ureter courses along the anterior edge of the psoas muscle

Question 4

What is the relationship of the ureter to the gonadal vessels?

Answer 4

The gonadal vessels cross ANTERIORLY to the ureter rom medial to lateral

Question 5

Where does the ureter cross from lateral to medial?

Answer 5

At the level of the sacral promontory

Over the bifurcation of the iliac vessels

Question 6

What are the two most common sites for ureteric injury in gynaecological surgery?

Answer 6

At the level of the

1. Uterine arteries
   - the ureter is within 2cm of the uterine vessels
2. Cardinal ligaments
   - the ureter is only 1.5-2cm lateral to the cervix

Question 7

What is the blood supply to the ureter?

Answer 7

Multiple small unnamed arterial branches of the renal, aorta, gonadal, internal iliac and middle rectal vessels

Question 8

What is the relationship of the blood supply of the ureter, to the ureter,
Superior and inferior to the iliacs

Answer 8

Superior to iliacs - vessels approach the ureter MEDIALLY
Inferior to iliacs - vessels approach the ureter LATERLLY

Clinically important when mobilising the ureter
Approach from other side so not to compromise blood supply

Question 9

What is the average length of the female urethra?

Answer 9

4cm

Its short length predisposes it to urinary infection