An Anatomical Study on Blood Supply of Ureter

Abstract

Introduction: The ureter receives segmental arterial supply which varies along its course. The present study attempts to determine the blood supply of ureter and to understand the variation of supply to the ureter. Materials and methods: The ureteral vascular pattern was studied in 42 cadavers-32 male and 10 female and also studied in 25 still born infants-20 male and 5 female which were procured from the Department of Anatomy, Mamatha medical college, khammam. Different types of injection methods were used to study the vascular pattern of ureter. Results: From the present study, on statistical analysation 98% of blood supply to ureter was through Renal and uterine arteries, 92% is through superior vesicle artery, 86% is by vaginal artery, 60% is by internal iliac, 52% by aortic, 44% by Gonadal, 36% by inferior vesical, 34% by common iliac, 16% by artery to vas, 14% by middle rectal and 12% is by capsular arteries. In this study the longitudinal vascular pattern of ureter is found to be 83.6%. Conclusion: It is observed from the study of vascular supply to ureter was significantly contributed by Renal arteries, uterine arteries, superior vesicle arteries and vaginal arteries. The present study also determines that Ureter at different age periods have the same sources of blood supply indicating that age has no effect on the vascularity and observed the vascular patterns of full time foetal and adult vascular patterns are the same. It is observed that the female ureter appears to have more liberal blood supply than in the male when the size of the arteries is taken into consideration.

Ureteric complications and left retroperitoneal abdominal aortic surgery

“…Further evidence for this as the aetiology is the arterial supply of the ureter is segmental with collateralization along a longitudinal adventitial plane from the kidney proximally to the bladder distally. 5 In this series, the earliest onset of symptoms relating to UC was 48 h with the latest presentation at 14 days. Early detection of UCs is difficult as symptoms and signs are invariably vague and nonspecific.…”

“…Despite this, there is little or no morbidity attributed to the left kidney and ureter in many published series specifically reporting the RP approach. 4,5,9,10 One of the few series examining renal tract complications following RP surgery was by Sheehan et al, who proposed that the anteromedial mobilization of the left kidney reduce the chances of UC developing during the RP approach. 14 Furthermore, they suggested renal tract traction injury, rather than ischaemic devascularization, as the major cause of UC.…”

“…The presentation with a necrotic left ureter 3 weeks following aortic surgery suggested an ischaemic aetiology, especially as an initial ureterogram was normal. Further evidence for this as the aetiology is the arterial supply of the ureter is segmental with collateralization along a longitudinal adventitial plane from the kidney proximally to the bladder distally 5 …”

“…Recent series describe the RP procedure with the left kidney left in situ posteriorly 1,11–13 with little or no mention of UC occurring. Despite this, there is little or no morbidity attributed to the left kidney and ureter in many published series specifically reporting the RP approach 4,5,9,10 …”

Special features of anatomic relations of ureters in gynecologic surgeries

“…Это ветви аорты, почечной артерии, семенной, общей подвздошной, внутренней подвздошной, верхней и нижней мочепузырных, маточной и средней прямокишечной. Обилие источников кровоснабжения тазовых отделов мочеточников, разветвленность артериальной сети усугубляют опасность их ранений [3].…”