Links to AMBOSS articles referenced below
“Invasive cervical cancer”: https://next.amboss.com/us/article/ZO0ZIT#7eb4ZG

“Overview of the urinary tract”: https://next.amboss.com/us/article/Rp0l6S#Ybb59af0ff704531ea44577ef304c4ed2

First Aid 2025 states the mechanism and direction: “lateral invasion can block ureters → hydronephrosis → renal failure” (p. 663) and, anatomically, “Water (ureters) flows over the iliacs and under the bridge (uterine artery or vas deferens).” (p. 599), which explains why lateral spread reaches the ureter.

NBME 29 has a cervical cancer vignette for a 50-year-old woman and in the answer explanation it states that cervical cancer “can result in obstruction of bilateral distal ureters near their insertion into the urinary bladder” this directly identifies the distal segment affected.

In the AMBOSS article “Invasive cervical cancer” the “Complications” subsection states - “Infiltration and compression of the ureter → urinary obstruction → hydronephrosis → kidney failure”- this describes what that lateral spread does at the distal ureter, this same article and also clarifies what happens when the bladder itself is involved and it’s usually related to vesicovaginal fistula not blockage of the ureters: “Other organs often affected by the spread of cervical cancer include the rectum, bladder, and vagina.” and “Fistula formation in locally advanced disease (e.g., rectovaginal, vesicovaginal, urethrovaginal fistula).”

Furthermore, in the AMBOSS article “Overview of the urinary tract” the “Ureters” subsection describes the distal course as “The ureters travel down the posterolateral surface of the urinary bladder towards its inferior region, where they insert into the trigone of the bladder.” This therefore explains that the distal ureter is to the side/back (posterolateral) of the bladder - not the anterior surface as the original card suggests.

Taken together, these sources all reflect on the same teaching point: the correct direction to cite for ureter involvement is lateral. Therefore, the card should be changed to reflect this.

Source: AMBOSS - https://next.amboss.com/us/article/ZO0ZIT#7eb4ZG