During a radical hysterectomy, the surgeon dissects the uterosacral ligament to mobilize the uterus. The ureter is most closely related to this ligament at what distance from the cervix?

• A 0.5 cm lateral to the cervix
• B 1.5 to 2 cm lateral to the cervix ✓
• C 3 to 4 cm lateral to the cervix
• D 5 to 6 cm lateral to the cervix

Explanation

The ureter passes approximately 1.5 to 2 cm lateral to the cervix as it courses inferior to the uterine artery and then forward toward the bladder base. This close relationship to the uterosacral ligament during radical hysterectomy makes the ureter vulnerable when clamping or dividing this ligament. Bailey and Love and standard operative gynaecology texts cite this 1.5 to 2 cm distance as the critical surgical landmark.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

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Written and medically reviewed by the StethoPrep medical team.