Alterations with age in the biomechanical behavior of human ureteral wall: Microstructure-based modeling

The human ureters have not been thoroughly explored from the biomechanics perspective, despite the wealth of such data for other soft-tissue types. This study was motivated by the need to use relevant biomechanical data from human ureters and microstructure-based material formulations for simulations of ureteral peristalsis and stenting. Our starting choice was the four-fiber family model that has proven its validity as a descriptor of the multiaxial response of cardiovascular tissues. The degree of model complexity, required for rigorous fits to passive quasi-static pressure-diameter-force data at several axial stretches, was systematically investigated. Ureteral segments from sixteen human autopsy subjects were evaluated. A diagonal and axial family model allowed equally-good fits as the full model for all age groups and ureteral regions; considerably better than those allowed by the phenomenological Fung-type model whose root-mean-square error of fitting was three-fold greater. This reduced model mimicked the structure seen in histologic sections, namely plentiful diagonal collagen fibers in the lamina propria and axial fibers in the muscle and adventitia. The paucity of elastin fibers and mixed muscle orientation justified the use of isotropic muscle-dominated matrix with small neo-Hookean parameter values. The significantly thicker lamina propria in the lower than the upper ureter of young subjects (312 ± 27 vs. 232 ± 26 μm; mean ± standard error) corroborated the significant regional differences in diagonal-fiber family parameter values. The significant muscle thickening with age (upper ureter: 373 ± 48 vs. 527 ± 67 μm; middle: 388 ± 29 vs. 575 ± 69 μm; lower: 440 ± 21 vs. 602 ± 71 μm) corroborated the significant age-related increase in axial-fiber family parameter values.