Deanna C Easley1, Steven D Abramowitch, Pamela A Moalli. 1. aDepartment of Bioengineering bDepartment of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Abstract
PURPOSE OF REVIEW: The pelvic floor is a complex assembly of connective tissues and striated muscles that simultaneously counteracts gravitational forces, inertial forces, and intra-abdominal pressures while maintaining the position of the pelvic organs. In 30% of women, injury or failure of the pelvic floor results in pelvic organ prolapse. Surgical treatments have high recurrence rates, due, in part, to a limited understanding of physiologic loading conditions. It is critical to apply biomechanics to help elucidate how altered loading conditions of the pelvis contribute to the development of pelvic organ prolapse and to define surgeries to restore normal support. RECENT FINDINGS: Evidence suggests the ewe is a potential animal model for studying vaginal properties and that uterosacral and cardinal ligaments experience significant creep, which may be affecting surgical outcomes. A new method of measuring ligament displacements in vivo was developed, and finite element models that simulate urethral support, pelvic floor dynamics, and the impact of episiotomies on the pelvic floor were studied. SUMMARY: The current review highlights some contributions over the past year, including mechanical testing and the creation of models, which are used to understand pelvic floor changes with loading and the impact of surgical procedures, to illustrate how biomechanics is being utilized.
PURPOSE OF REVIEW: The pelvic floor is a complex assembly of connective tissues and striated muscles that simultaneously counteracts gravitational forces, inertial forces, and intra-abdominal pressures while maintaining the position of the pelvic organs. In 30% of women, injury or failure of the pelvic floor results in pelvic organ prolapse. Surgical treatments have high recurrence rates, due, in part, to a limited understanding of physiologic loading conditions. It is critical to apply biomechanics to help elucidate how altered loading conditions of the pelvis contribute to the development of pelvic organ prolapse and to define surgeries to restore normal support. RECENT FINDINGS: Evidence suggests the ewe is a potential animal model for studying vaginal properties and that uterosacral and cardinal ligaments experience significant creep, which may be affecting surgical outcomes. A new method of measuring ligament displacements in vivo was developed, and finite element models that simulate urethral support, pelvic floor dynamics, and the impact of episiotomies on the pelvic floor were studied. SUMMARY: The current review highlights some contributions over the past year, including mechanical testing and the creation of models, which are used to understand pelvic floor changes with loading and the impact of surgical procedures, to illustrate how biomechanics is being utilized.
Authors: Ting Tan; Frances M Davis; Daniel D Gruber; Jason C Massengill; John L Robertson; Raffaella De Vita Journal: J Mech Behav Biomed Mater Date: 2014-11-26
Authors: Carolyn W Swenson; Jiajia Luo; Luyun Chen; James A Ashton-Miller; John O L DeLancey Journal: Int Urogynecol J Date: 2016-02-27 Impact factor: 2.894
Authors: Yvonne Hsu; Luyun Chen; Aimee Summers; James A Ashton-Miller; John O L DeLancey; James O L DeLancey Journal: Int Urogynecol J Pelvic Floor Dysfunct Date: 2007-06-20
Authors: Jennifer M Wu; Catherine A Matthews; Mitchell M Conover; Virginia Pate; Michele Jonsson Funk Journal: Obstet Gynecol Date: 2014-06 Impact factor: 7.661
Authors: Olivier Mayeur; Jean-François Witz; Pauline Lecomte; Mathias Brieu; Michel Cosson; Karol Miller Journal: Ann Biomed Eng Date: 2015-07-28 Impact factor: 3.934
Authors: Vladimir Egorov; Peter Takacs; S Abbas Shobeiri; Lennox Hoyte; Vincent Lucente; Heather van Raalte; Noune Sarvazyan Journal: Female Pelvic Med Reconstr Surg Date: 2021-01-01 Impact factor: 1.913
Authors: Vladimir Egorov; Heather van Raalte; Peter Takacs; S Abbas Shobeiri; Vincent Lucente; Lennox Hoyte Journal: Int Urogynecol J Date: 2022-03-01 Impact factor: 1.932
Authors: Daiana Priscila Rodrigues-de-Souza; Sandra Alcaraz-Clariana; Lourdes García-Luque; Cristina Carmona-Pérez; Juan Luis Garrido-Castro; Inés Cruz-Medel; Paula R Camargo; Francisco Alburquerque-Sendín Journal: Diagnostics (Basel) Date: 2021-12-09