In the female, the ureter is at risk of injury during hysterectomy at a point where it passes close to the lateral fornix of the vagina. At this point the ureter lies medial to the:

• A Uterine artery (ureter passes under the uterine artery) ✓
• B Uterosacral ligament
• C Ovarian ligament
• D Round ligament

Explanation

The classic danger point for ureteric injury during hysterectomy is where the uterine artery crosses over (superior to) the ureter — classically remembered as 'water under the bridge' (artery = bridge, ureter = water). The ureter passes medial to the uterine artery approximately 1.5 cm lateral to the cervix, at the level of the vaginal fornix. Blind clamping of the uterine artery at this point can inadvertently include the ureter. The ureteral course here is also very close to the lateral vaginal fornix.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.