The ureteric wall is a complex multi-layered structure. The ureter shows variation in passive mechanical properties, histological morphology and insertion forces along the anatomical length. Ureter mechanical properties also vary depending on the direction of tensile testing and the anatomical region tested. Compliance is greatest in the proximal ureter and lower in the distal ureter, which contributes to the role of the ureter as a high-resistance sphincter. Similar to other human tissues, the ureteric wall remodels with age, resulting in changes to the mechanical properties. The passive mechanical properties of the ureter vary between species, and variation in tissue storage and testing methods limits comparison across some studies. Knowledge of the morphological and mechanical properties of the ureteric wall can aid in understanding urine transport and safety thresholds in surgical techniques. Indeed, various factors alter the forces required to insert access sheaths or scopes into the ureter, including sheath diameter, safety wires and medications. Future studies on human ureteric tissue both in vivo and ex vivo are required to understand the mechanical properties of the ureter and how forces influence these properties. Testing of instrument insertion forces in humans with a focus on defining safe upper limits and techniques to reduce trauma are also needed. Last, evaluation of dilatation limits in the mid and proximal ureter and clarification of tensile strength anisotropy in human specimens are necessary.

输尿管壁是一个复杂的多层结构。输尿管沿解剖长度显示被动机械特性、组织学形态和插入力的变化。输尿管机械性能也根据拉伸测试的方向和测试的解剖区域而变化。近端输尿管的顺应性最高，远端输尿管的顺应性较低，这有助于输尿管作为高阻力括约肌的作用。与其他人体组织类似，输尿管壁随着年龄的增长而重塑，导致机械性能发生变化。输尿管的被动机械特性因物种而异，并且组织储存和测试方法的变化限制了一些研究之间的比较。了解输尿管壁的形态和机械特性有助于了解手术技术中的尿液输送和安全阈值。事实上，多种因素会改变将接入鞘管或镜插入输尿管所需的力，包括鞘管直径、安全丝和药物。未来需要对人体输尿管组织进行体内和离体研究，以了解输尿管的机械特性以及力如何影响这些特性。还需要对人体的器械插入力进行测试，重点是确定安全上限和减少创伤的技术。最后，有必要评估输尿管中部和近端的扩张极限，并澄清人体标本的拉伸强度各向异性。