The ureter passes beneath which ligament in the female pelvis, creating the risk of ureteric ligation during hysterectomy?

• A Cardinal (Mackenrodt's) ligament — the ureter runs 1-2 cm lateral to the cervix beneath this ligament ✓
• B Round ligament of the uterus
• C Utero-ovarian ligament
• D Broad ligament (peritoneal fold) at the level of the uterine fundus

Explanation

The ureter passes beneath the cardinal (transverse cervical / Mackenrodt's) ligament in the parametrium, running approximately 1-2 cm lateral to the cervix and vault of the vagina, crossing close to the uterine artery ('water flows under the bridge' — the ureter passes under the uterine artery). This anatomical proximity is the primary reason for ureteric injury (kinking, ligation, or transection) during clamping of the uterine vessels or parametrium in hysterectomy. The round ligament and utero-ovarian ligament are more superior structures. The broad ligament is a peritoneal fold, not a fibromuscular ligament.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.