Evaluation of the tensile strength of the human ureter - Preliminary results.

Introduction: 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 have determined the tensile strength of the human ureter. Therefore, the purpose of this work was to determine the tensile strength of the human ureter. Materials and Methods: We harvested 11 human proximal ureters from patients who were undergoing nephrectomy for either kidney tumors or non-functioning 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. Results: 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 to 502.89±55.85 Ncm-2 in the distal portion (p=0.08). Conclusions: 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 in order to prevent complications.