Ureter

Function

The ureter is a 25–30 cm muscular tube milking urine downward by peristaltic waves three times a minute. It descends retroperitoneally on psoas, crosses the pelvic brim over the bifurcation of the common iliac artery, then swings medially to enter the bladder base obliquely.

That oblique intramural course is the anti-reflux valve: bladder pressure compresses the tunnel shut, keeping urine moving one way. Three narrowings — the pelvi-ureteric junction, the pelvic brim crossing and the vesico-ureteric junction — trap stones and define where colic lodges.

Blood supply

Renal, gonadal, common iliac and superior/inferior vesical arteries in a longitudinal chain.

Nerve supply

T11–L2 sympathetic via the aortic and hypogastric plexuses; pain referred from loin to groin.

Clinical relevance

Ureteric calculus

Stones obstruct at the narrowings — the writhing colic of 10/10 pain radiating loin-to-groin, with microscopic haematuria.

Vesicoureteral reflux

A short intramural tunnel lets infected bladder urine reflux — the childhood mechanism of renal scarring.

Related conditions

• Kidney stones