ObjectivesTo define the natural distensibility of the human ureter and evaluate the impact of other possibly favourable factors on ureteric distensibility.Patients and MethodsA total of 101 patients undergoing ureteroscopic stone removal or percutaneous nephrolithotomy underwent ureteric sizing using sequential passage of 37‐cm urethral dilators in 2‐F increments while attached to a unique force sensor. Insertion forces were limited to 6 N. After 6 N was attained, an appropriately sized ureteric access sheath was passed. At the conclusion of each procedure, Post‐Ureteroscopic Lesion Scale score was determined.ResultsUrethral dilators were passed in 61% of patients at ≤14 F; 39% of patients accepted urethral dilators of ≥16 F. The mean dilator size was 14 F. Multivariate logistic regression analysis revealed that preprocedural ureteric stenting and antibiotic use favoured passage of 16‐F dilators (odds ratio [OR] 5.16, 95% confidence interval [CI] 1.70–15.62 [P = 0.004] and OR 5.15, 95% CI 1.743–15.243 [P = 0.003], respectively). Neither tamsulosin nor prior urinary tract infection had an impact on ureteric size (OR 0.765, 95% CI 0.281–2.084 [P = 0.601], OR 1.049, 95% CI 0.269–4.089 [P = 0.945], respectively).ConclusionUsing continuous insertion force monitoring and a 6‐N threshold, the majority of unstented adult human ureters within our patient population safely accommodated a 14‐F dilator. Safe passage of a 16‐F dilator at the 6‐N threshold was more likely among patients with a preexisting indwelling ureteric stent or patients who were treated with antibiotics within a week of the procedure.

中文翻译：

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人输尿管自然扩张性的临床测定：初步研究


目的定义人输尿管的自然扩张性，并评估其他可能有利因素对输尿管扩张性的影响。患者和方法共有 101 名接受输尿管镜取石或经皮肾镜取石术的患者在连接到独特的力传感器时，使用 37 cm 尿道扩张器以 2-F 的增量顺序通过进行输尿管大小调整。插入力限制为 6 N。达到 6 N 后，通过适当尺寸的输尿管通路鞘。在每个手术结束时，确定输尿管镜后病变量表评分。结果61% 的患者在 ≤14 F 时排出尿道扩张器;39% 的患者接受了 ≥16 F 的尿道扩张器。平均扩张器大小为 14 F。多变量 logistic 回归分析显示，术前输尿管支架置入术和抗生素使用有利于 16-F 扩张器的排出（比值比 [OR] 5.16,95% 置信区间 [CI] 1.70-15.62 [P = 0.004] 和 OR 5.15,95% CI 1.743-15.243 [P = 0.003]）。坦索罗辛和既往尿路感染均对输尿管大小没有影响 （OR 0.765， 95% CI 0.281–2.084 [P = 0.601]，OR 1.049， 95% CI 0.269–4.089 [P = 0.945]）。结论使用连续插入力监测和 6-N 阈值，我们患者群体中的大多数未支架成人输尿管安全地容纳了 14-F 扩张器。在已有留置输尿管支架的患者或在手术后一周内接受抗生素治疗的患者中，16-F 扩张器在 6-N 阈值下安全通过的可能性更大。