intramural ureter

The intramural ureter is the terminal segment of the ureter that passes through the wall of the urinary bladder. It is continuous with the distal ureter and extends obliquely through the bladder wall, terminating at the ureteric orifice on the trigone of the bladder interior.

The intramural ureter is located within the posterior wall of the urinary bladder. It courses obliquely through the bladder musculature for approximately 1 to 2 centimeters before opening into the bladder lumen at the ureteric orifice.

The intramural ureter conducts urine into the bladder and, importantly, is aperistaltic — meaning it does not undergo active peristaltic contractions. Its oblique passage through the bladder wall creates a passive valve mechanism that helps prevent vesicoureteral reflux, the backflow of urine from the bladder into the ureters.

The intramural ureter is involved in conditions such as vesicoureteral reflux, ureterovesical junction obstruction, and various congenital ureteral anomalies. These conditions are evaluated by healthcare professionals using imaging and other diagnostic tools.

The intramural ureter can be assessed with CT urography, voiding cystourethrography (to evaluate reflux), and intravenous pyelography. Cystoscopy allows direct endoscopic visualization of the ureteric orifice where the intramural ureter opens into the bladder.