Ureteric Orifice Right & Left
The renal pelvis is the starting point for the ureter, and the hilus at the kidney’s medial border is where it exits the body. In the abdominal region, the ureter travels in a caudal, retroperitoneal fashion. The ureter passes intermurally between the urinary bladder’s tunica muscularis and tunica mucosa before opening. The ureteric orifice refers to the slit in the ureter that is located near the lumen of the urinary bladder. The ureter is a tubular organ that is simple in structure. It includes the tunica adventitia, muscularis, and mucosa.
The opening of the ureter in the bladder is known as the ureteric orifice, and it is located at the postero-lateral angles of the trigonum vesicae. Typically, it has a slit-like shape and is approximately 2.5 cm apart in a contracted bladder.
The urine bladder’s entrance into the urethra is known as the internal urethral orifice. It is normally crescent-shaped and located near the apex of the trigonum vesicae, at the most dependent section of the bladder. The right and left ureteric orifices resemble slits in appearance most of the time. When the bladder contracts, the detrusor muscle contracts around the ureteric orifices, preventing vesicoureteral reflux.
Ureteric Orifice Function
The ureteric orifice connects the ureter to the bladder and serves as the pathway for urine to travel from the ureter into the bladder. To avoid vesicoureteral reflux, the bladder’s detrusor muscle tightens around the ureteric orifices. The internal urethral orifice, which connects the urinary bladder to the urethra, is responsible for letting urine pass from the bladder into the urethra. The external urethral orifice allows urine to leave the body in both men and women.
Ureteric Orifice Obstruction
The ureteric orifice is one of the urinary system’s many locations where obstruction can develop. Ectopic ureteral orifice, a congenital anomaly, can cause obstruction when the ureteral orifice is positioned near the bladder neck or urethra. In females, obstruction only affects ureters that end inside the urinary tract. Obliteration of the ureteric orifice can also produce obstruction, which can be treated with a standardized endoscopic procedure. The internal urethral orifice can also be obstructed, as in the case of the uvula vesicae resulting from the middle lobe of the prostate. The external urethral orifice can also be obstructed, as in the case of epispadias, a congenital disease in which the urethra ends in an aperture on the dorsum of the penis.
Ureteric Orifice Cancer & Treatment
Cancer of the ureter opening in the bladder, also known as ureteric orifice cancer, is extremely uncommon. Urinary blood, urination pain, and frequent urination are all signs of ureteric orifice cancer. Ureteric orifice cancer is often treated with surgery, chemotherapy, or radiation treatment.
Transitional cells, which are cells in the bladder’s lining, are where renal pelvic and ureteral cancer most frequently start. Squamous cells, which are flat cells found in the outermost layer of the skin and line the respiratory and digestive passages as well as hollow organs, are the origin of approximately ten percent of all ureter cancers. According to the size of the tumor and whether or not the cancer cells have moved outside of the ureter or renal pelvis, ureter cancer is classified into several stages.
Localized cancer is still present at the site of genesis and has not progressed beyond the kidney or ureter. Regional cancers spread to the kidney’s adjacent tissue and/or lymph nodes, whereas metastatic cancers spread to other organs.
Ureteric orifice cancer is treated with wide, thorough excision of the whole orifice area. Removal of ureteral cancer typically requires surgery, the extent of which is determined by the tumor’s size and location. Only a small section of the ureter may need to be removed during surgery for extremely early-stage ureteral cancer, whereas for more advanced cases, the afflicted ureter, its accompanying kidney, and a portion of the bladder may all need to be removed. When standard therapies fail to control advanced ureteral carcinoma, immunotherapy is sometimes used. A slightly invasive endoscopic procedure can be used to fix an obstructed ureteric orifice.