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Biomechanical study on the bladder neck and urethral positions: simulation of impairment of the pelvic ligaments
- Source :
- Journal of biomechanics. 48(2)
- Publication Year :
- 2014
-
Abstract
- Excessive mobility of the bladder neck and urethra are common features in stress urinary incontinence. We aimed at assessing, through computational modelling, the bladder neck position taking into account progressive impairment of the pelvic ligaments. Magnetic resonance images of a young healthy female were used to build a computational model of the pelvic cavity. Appropriate material properties and constitutive models were defined. The impairment of the ligaments was simulated by mimicking a reduction in their stiffness. For healthy ligaments, valsalva maneuver led to an increase in the α angle (between the bladder neck-symphysis pubis and the main of the symphysis) from 91.8° (at rest) to 105.7°, and 5.7 mm of bladder neck dislocation, which was similar to dynamic imaging of the same woman (α angle from 80° to 103.3°, and 5mm of bladder neck movement). For 95% impairment, they enlarged to 124.28° and 12 mm. Impairment to the pubourethral ligaments had higher effect than that of vaginal support (115° vs. 108°, and 9.1 vs. 7.3mm). Numerical simulation could predict urethral motion during valsalva maneuver, for both healthy and impaired ligaments. Results were similar to those of continent women and women with stress urinary incontinence published in the literature. Biomechanical analysis of the pubourethral ligaments complements the biomechanical study of the pelvic cavity in urinary incontinence. It may be useful in young women presenting stress urinary incontinence without imaging evidence of urethral and muscle lesions or organ descend during valsalva, and for whom fascial damage are not expected.
- Subjects :
- Adult
Male
medicine.medical_specialty
Symphysis
Valsalva Maneuver
medicine.medical_treatment
Movement
Finite Element Analysis
Urinary Bladder
Biomedical Engineering
Biophysics
Urinary incontinence
Pelvis
Pelvic floor dysfunction
Urethra
medicine
Valsalva maneuver
Humans
Orthopedics and Sports Medicine
Mechanical Phenomena
Ligaments
medicine.diagnostic_test
business.industry
Rehabilitation
Magnetic resonance imaging
Anatomy
Pelvic cavity
medicine.disease
Magnetic Resonance Imaging
Surgery
Biomechanical Phenomena
Neck of urinary bladder
medicine.anatomical_structure
Female
medicine.symptom
business
Subjects
Details
- ISSN :
- 18732380
- Volume :
- 48
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Journal of biomechanics
- Accession number :
- edsair.doi.dedup.....02f1fc28d909be5f20c724c2ebaf8c37