The uterine artery is ligated during hysterectomy. The ureter is immediately at risk because of their anatomical relationship. At what specific point is the ureter closest to the uterine artery?
- A At the base of the broad ligament, 1.5–2 cm lateral to the cervix where the uterine artery crosses over the ureter ✓
- B At the pelvic brim where the ureter crosses the bifurcation of the common iliac artery
- C At the level of the ischial spine
- D At the ureterovesical junction
Correct answer: A. At the base of the broad ligament, 1.5–2 cm lateral to the cervix where the uterine artery crosses over the ureter
Explanation
The classic 'water under the bridge' relationship: the uterine artery crosses superior to (over) the ureter at the base of the broad ligament, approximately 1.5–2 cm lateral to the uterine cervix. This is the most common site of ureteric injury during hysterectomy. The surgical dictum 'identify the ureter before ligating the uterine artery' directly addresses this risk. The ureter also crosses the common iliac bifurcation at the pelvic brim, but that site is less surgically relevant for uterine artery ligation.
Reference: BD Chaurasia's Human Anatomy, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.