The male ureters follow a similar course from the renal pelvis to the bladder, but their relations differ. Both pass medially and inferiorly anterior to the psoas major muscle, then curve laterally before returning to a medial course and piercing the base of the bladder. They cross anterior to the bifurcation of the common iliac arteries and veins.
Right Ureter
The right ureter arises posterior to the descending duodenum. It descends lateral to the inferior vena cava in the retroperitoneum, crossed anteriorly by the right colic vessels, root of the mesentery and terminal ileum.
Left Ureter
The left ureter arises posterior to the jejunum, and descends lateral to the aorta. It is crossed by the testicular artery and left colic artery superiorly and the mesentery of the sigmoid colon inferiorly.
Common Pelvic Course of the Ureters
Upon entering the pelvis, the ureters course medially and pass between the vas deferens (anteriorly) and the seminal glands (posteriorly). The ureters pierce the bladder wall and follow an oblique course through the muscle to empty into the trigone.
