Editing Urinary tract (section)

=== '''Course''' ===

** Retroperitoneal, along      surface of psoas major, in front of tips of transverse processes
** Crosses IN FRONT of      genitofemoral nerve
** Crosses BEHIND the gonadal      vessels, to lie medial to them
** '''Right:''' upper part is protected      behind D3. Lower down crossed anteriorly by right colic and ileocolic      vessels and root of mesentery. Protect it during RHC, even if it's not      visualised, by ensuring gonadal vessels lie posteriorly.
** '''Left:''' lateral to IMA and IMV,      crossed anteriorly by left colic vessels, and by the apex of the sigmoid      mesocolon at the pelvic brim.
** On '''both''' sides, leaves the psoas      muscle at the bifurcation of the common iliac artery, crossing      anteriorly, and passes into the pelvis anterior to SIJ. Course anteriorly      to internal iliac vessels down the lateral pelvic sidewall.
** At the level of the ischial      spine, turn forwards and medially to enter the posterolateral wall of the      bladder, where it runs an oblique 1-2cm course, before opening into the      bladder at the internal ureteric orifice.
*** In men, they are posterior       to the vas.
*** In women, the ureters are       immediately posterior to the ovaries, then cross in the base of the       broad ligaments, where they pass behind and then under the uterine       arteries.
*** Ureters tend to lie       anterior to dissection around the rectum.
** Injuries most commonly occur      near the lower pole of the kidney on the left, or in the pelvis if      anatomy is difficult and distorted