The ureters are narrow, thick-walled ducts, about 25–30 centimetres (9.8–11.8 inches) in length and from four to five millimetres (0.16 to 0.2 inch) in diameter, that transport the urine from the kidneys to the urinary bladder. Throughout their course they lie behind the peritoneum, the lining of the abdomen and pelvis, and are attached to it by connective tissue.
In both sexes the ureters enter the bladder wall about five centimetres apart, although this distance is increased when the bladder is distended with urine. The ureters run obliquely through the muscular wall of the bladder for nearly two centimetres before opening into the bladder cavity through narrow apertures. This oblique course provides a kind of valvular mechanism; when the bladder becomes distended it presses against the part of each ureter that is in the muscular wall of the bladder, and this helps to prevent the flow of urine back into the ureters from the bladder.
The wall of the ureter has three layers, the adventitia, or outer layer; the intermediate, muscular layer; and the lining, made up of mucous membrane. The adventitia consists of fibroelastic connective tissue that merges with the connective tissue behind the peritoneum. The muscular coat is composed of smooth (involuntary) muscle fibres and, in the upper two-thirds of the ureter, has two layers—an inner layer of fibres arranged longitudinally and an outer layer disposed circularly. In the lower third of the ureter an additional longitudinal layer appears on the outside of the vessel. As each ureter extends into the bladder wall its circular fibres disappear, but its longitudinal fibres extend almost as far as the mucous membrane lining the bladder.
The mucous membrane lining increases in thickness from the renal pelvis downward. Thus, in the pelvis and the calyxes of the kidney the lining is two to three cells deep; in the ureter, four to five cells thick; and in the bladder, six to eight cells. The mucous membrane of the ureters is arranged in longitudinal folds, permitting considerable dilation of the channel. There are no true glands in the mucous membrane of the ureter or of the renal pelvis. The chief propelling force for the passage of urine from the kidney to the bladder is produced by peristaltic (wavelike) movements in the ureter muscles.
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