A 2D equivalent mechanical model of the whole pelvic floor and impairment simulation. (6th November 2022)

• Record Type: Journal Article
• Authors: Xie, Jiachen; Li, Song; Yao, Tingqiang; Shen, Jihong
• Is Part Of: International journal for numerical methods in biomedical engineering. Volume 39:Number 1(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-11-06
• Subjects: anterior vaginal prolapse (AVP) -- biomechanics -- organ prolapse -- tissue impairment -- whole pelvic floor model; Biomedical engineering -- Periodicals; Imaging systems in medicine -- Periodicals; Numerical analysis -- Periodicals; Engineering mathematics -- Periodicals; 610.28
• DOI: 10.1002/cnm.3659
• Languages: English
• ISSNs: 2040-7939

Abstract

Abstract: We developed a complete 2D equivalent mechanical model of the pelvic floor based on magnetic resonance imaging (MRI) images of a 35‐year‐old healthy woman. This model can simulate anterior vaginal prolapse (AVP) due to soft tissue impairment. Thus, we can study the mechanism of prolapse formation from a mechanical perspective and improve the assessment and treatment of the condition in clinical practice. Based on 2D MRI image parameter measurements and computer‐aided design methods, the 2D equivalent mechanical model of the whole pelvic floor in the sagittal plane was accurately reconstructed, which includes all necessary tissues of the pelvic floor system. Material parameters were mainly from the literature. We simulated the impairment by reducing the tissue's mechanical properties, and numerical simulations predicted the mechanical response and morphological changes of the healthy and impaired pelvic floor in different states. In six intra‐abdominal pressure (IAP) states (8.4–208.9 cmH2 O), the maximum cervical descent in the impaired pelvic floor was 0.3–18.521 mm, which was much greater than that in the healthy pelvic floor (0.14–6.55 mm). Once the impairment occurred (0%–25%), there was a significant increase in maximum displacement, stress, and cervical descent (30.9–36.5 mm, 0.56–1.12 MPa, 4.6–12.1 mm), and a clinically similar prolapse shape occurred. Simple supine and standing will not cause prolapse. The formation of prolapse is closely related to vaginal tissue impairment. In the standing position, the main forces on the healthy pelvic floor system are distributed horizontally posteriorly and inferiorly, reducing the burden in the vertically downward direction. Abstract : We developed a complete two‐dimensional equivalent mechanical model of the pelvic floor based on magnetic resonance imaging (MRI) images. It can simulate anterior vaginal prolapse (AVP) due to soft tissue impairment. The results show that the formation of prolapse is closely related to the impairment of the anterior vaginal wall. Simple supine and standing does not lead to prolapse, but prolapse occurs when the intra‐abdominal pressure ( IAP) value reaches the Valsalva action‐related value. In the standing position, the main forces on the healthy pelvic floor system are distributed horizontally posteriorly and inferiorly, reducing the burden in the vertically downward direction.