Fig. 149. Pelvic Organs of Female seen from above and in front. 



Ureter. 



Woman aged 50. Intestines removed as far as the Rectum, Uterus retroverted ; 

 Left Appendages of Uterus removed. The Right Fallopian Tube is drawn 

 upwards and its fimbriated extremity thrown upwards oi'er the brim of the 

 true pelvis. The Abdominal Opening of the Fallopian Tube and the Ovarian 

 Fossa are thus exposed; the ovary is somewhat drawn upwards by the tube. 

 On the left side the peritoneum covering tlie important vessels and nerves has 

 been removed, but the portion forming the posterior layer of the Broad Liga- 

 ment has been preserved intact and the round ligament retained in situ. On the 

 left side the Lymphatic Glands are exposed and their corresponding imaginary 

 situations on the right side are depicted through the transparent peritoneum. 



By Waldeyer the lateral wall of the true pelvis has been divided into 

 the following fossae: Paravesical, Obturator, Hypogastric (Para-Iliac) bounded by 

 the Round Ligament (in the Male — Vas Deferens) and the Ureter. 



When the Bladder is empty the Paravesical Fossa is divided into an 

 anterior and posterior part by the Transverse Vesical Fold; the anterior part 

 belongs more to the Anterior Abdominal Wall, the posterior part can be fully 

 seen when the Uterus is retroverted. The Obturator Fossa in the depth of which 

 the Obturator Vessels and Nerve run over the surface of the Obturator Internus 

 Muscle contains the Ovarian Fossa which may be a simple groove or a deep 

 alcove against which the lateral half of the Ovary lies while its posterior border 

 remains free and rounded. 



The Ovary lies on the Uterine Artery touching the Ureter: according to 

 the size of this organ and the position of the Internal Iliac Vessels it reaches or 

 extends beyond the Internal Iliac Vessels, as far as the lower border of the 

 External Iliac Vein. 



The most posterior fossa is the H3'pogastric (Para-Iliac) Fossa in which 

 the Pyriformis Muscle and on this muscle the Sacral Plexus are found. 



The Ureter generally enters the True Pelvis at the bifurcation of the 

 Common Iliac Artery passing over the External Iliac Vessels and the Umbilico- 

 Vesical Trunk to lie between the Internal Iliac Vessels and the Uterine Artery and 

 covered for some distance by the broad ligament and the Vessels to the Append- 

 ages. In this part of its course the Ureter lies directly under the Peritoneum. 

 Further forwards, in front of the Broad Ligament, the Uterine Artery crosses 

 over and in front of the Ureter as it leaves the pelvic wall and approaches the 

 Vaginal Portion of the Uterus. It is at the level of the Internal Os (where the 

 Uterine Artery bifurcates — Waldeyer) that the Uterine Artery crosses the 

 Ureter. The Ureter comes very near the Vaginal Portion of the Uterus (cf. 

 dotted line) as it curves round it laterally to open into the bladder. 



The Ureter is only separated from the Vaginal Portion of the Uterus by 

 the vessels in the cellular tissue of the Parametrium (Branches of the Uterine 

 Artery and Utero- Vaginal Venous Plexus). On its outer side lies the Vesico- 

 vaginal Venous Plexus. These Plexuses communicate freely so that the Ureter 

 is embedded in a venous plexus. 



