Henry Gray (18251861). Anatomy of the Human Body. 1918.
The Ureter Proper measures from 25 to 30 cm. in length, and is a thick-walled narrow cylindrical tube which is directly continuous near the lower end of the kidney with the tapering extremity of the renal pelvis. It runs downward and medialward in front of the Psoas major and, entering the pelvic cavity, finally opens into the fundus of the bladder.
The abdominal part (pars abdominalis) lies behind the peritoneum on the medial part of the Psoas major, and is crossed obliquely by the internal spermatic vessels. It enters the pelvic cavity by crossing either the termination of the common, or the commencement of the external, iliac vessels.
At its origin the right ureter is usually covered by the descending part of the duodenum, and in its course downward lies to the right of the inferior vena cava, and is crossed by the right colic and ileocolic vessels, while near the superior aperture of the pelvis it passes behind the lower part of the mesentery and the terminal part of the ileum. The left ureter is crossed by the left colic vessels, and near the superior aperture of the pelvis passes behind the sigmoid colon and its mesentery.
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 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