Shilo Yaniv, Pichamuthu Joseph E, Averch Timothy D, Vorp David A
1 Department of Urology, University of Pittsburgh Medical Center , Pittsburgh, Pennsylvania.
J Endourol. 2014 Dec;28(12):1470-3. doi: 10.1089/end.2014.0226.
Ureteral injuries such as avulsion are directly related to mechanical damage of the ureter. Understanding the tensile strength of this tissue may assist in prevention of iatrogenic injuries. Few published studies have looked at the mechanical properties of the animal ureter and, of those, none has determined the tensile strength of the human ureter. Therefore, the purpose of this work was to determine the tensile strength of the human ureter.
We harvested 11 human proximal ureters from patients who were undergoing nephrectomy for either kidney tumors or nonfunctioning kidney. The specimens were then cut into multiple circumferentially and longitudinally oriented tissue strips for tensile testing. Strips were uniaxially stretched to failure in a tensile testing machine. The corresponding force and displacement were recorded. Finally, stress at failure was noted as the tensile strength of the sample. Circumferential tensile strength was also compared in the proximal and distal regions of the specimens.
The tensile strength of the ureter in circumferential and longitudinal orientations was found to be 457.52±33.74 Ncm(-2) and 902.43±122.08 Ncm(-2), respectively (P<0.001). The circumferential strength in the proximal portion of the ureter was 409.89±35.13 Ncm(-2) in comparison with 502.89±55.85 Ncm(-2) in the distal portion (P=0.08).
The circumferential tensile strength of the ureter was found to be significantly lower than the longitudinal strength. Circumferential tensile strength was also lower with more proximal parts of the ureter. This information may be important for the design of "intelligent" devices and simulators to prevent complications.
输尿管撕脱等损伤与输尿管的机械性损伤直接相关。了解该组织的抗张强度可能有助于预防医源性损伤。很少有已发表的研究探讨动物输尿管的力学性能,而且在这些研究中,没有一项确定了人类输尿管的抗张强度。因此,本研究的目的是确定人类输尿管的抗张强度。
我们从因肾肿瘤或无功能肾而接受肾切除术的患者身上获取了11条人类近端输尿管。然后将标本切成多个周向和纵向的组织条进行拉伸试验。组织条在拉伸试验机中进行单轴拉伸直至破坏。记录相应的力和位移。最后,将破坏时的应力记为样品的抗张强度。还比较了标本近端和远端区域的周向抗张强度。
发现输尿管周向和纵向的抗张强度分别为457.52±33.74 Ncm⁻²和902.43±122.08 Ncm⁻²(P<0.001)。输尿管近端的周向强度为409.89±35.13 Ncm⁻²,而远端为502.89±55.85 Ncm⁻²(P=0.08)。
发现输尿管的周向抗张强度明显低于纵向强度。输尿管越靠近近端,周向抗张强度越低。这些信息对于设计“智能”设备和模拟器以预防并发症可能很重要。