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Old 07-26-2012
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Question Ureter Relation Confusion!!

The ureter passes under the Uterine artery in the transverse cerival ligament..is what FA says. So there is risk of accidental ligation of ureter while doing a hysterectomy.

But at some other places, it says the Ureter passes under the suspensory ligament of tha ovary and hence it can be ligated during oophorectomy!! How i am confused.

Does pass under BOTH of these arteries?? If id does, then what are we supposed to asnwer when bpth those arteries/ligaments shopw up in the options????????????????????

I hope someone can clear this confusion for me. Thanks
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Old 07-27-2012
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Depends on the procedure, I guess. Ureter is initially medial to the suspensory ligament/ovarian artery and then passes below it at around the level of pelvic brim.


Its posterior to the uterine artery and hooks under it in the broad ligamemt. This is where its injured during a hysterectomy(while ligating the travservse/mackenrodts ligament).
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Old 07-27-2012
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hmmmm..ill try clear the air in my way

first, at the suspensory ligament level-the ureter is situated medial to the ovarian vessels and in close relationship to them. Hence ureters can be accidentally ligated while performing oophorectomy (which could be a part of total hysterectomy or just ovaries removal)

at the transverse cervical ligament--ureter lies deep and medial to uterine artery and again they are prone for accidental ligation while severing this ligament---which is invariably a part of hysterectomy

so if they give oophorectomy, the correct choice is suspensory lig and if they mention hysterectomy, the answer could well include both ligaments(in this scenario, only one of the ligaments will be listed in the options)

i found one question in a NBME(dont remem exactly) where they listed only suspensory lig in hysterectomy case so do not panic, the options shall be clear......
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