Biaxial mechanical properties of swine uterosacral and cardinal ligaments

Becker, Winston R.; Vita, R. De

doi:10.1007/s10237-014-0621-5

Cited by 26 publications

(19 citation statements)

References 43 publications

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“…A more complete understanding of ligament mechanics depends on recognizing that the ligaments are not elastic structures. These properties have been demonstrated in both the cardinal and uterosacral ligaments in animals in vitro 48 and in human in vivo. 49 …”

Section: Levator Ani Musclementioning

confidence: 89%

What's new in the functional anatomy of pelvic organ prolapse?

DeLancey¹

2016

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of Review Provide an evidence-based review of pelvic floor functional anatomy related to pelvic organ prolapse. Recent Findings Pelvic organ support depends on interactions between the levator ani muscle and pelvic connective tissues. Muscle failure exposes the vaginal wall a pressure differential producing abnormal tension on the attachments of the pelvic organs to the pelvic side-wall. Birth-induced injury to the pubococcygeal portion of the levator ani muscle is seen in 55% of women with prolapse and 16% of women with normal support. Failure of the connective tissue attachments between the uterus and vagina to the pelvic wall (cardinal, uterosacral, paravaginal) are strongly related with prolapse (effect sizes ~2.5) and are also highly correlated with one another (r ~0.85). Small differences exist with prolapse in factors involving the vaginal wall length and width (effect sizes ~1). The primary difference in ligament properties between women with and without prolapse is found in ligament length. Only minor differences in ligament stiffness are seen. Summary Pelvic organ prolapse occurs due to injury to the levator ani muscles and failure of the connections between the pelvic organs to the pelvic sidewall. Abnormalities of the vaginal wall fascial tissues may play a minor role.

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Section: Levator Ani Musclementioning

confidence: 89%

What's new in the functional anatomy of pelvic organ prolapse?

DeLancey¹

2016

Current Opinion in Obstetrics &Amp; Gynecology

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“…The smooth muscle fraction of the round ligament in women with uterine prolapse significantly decreases compared to that of women without prolapse [84]. [76,78,87,[92][93][94][95] and planar biaxial tests [96,97]. Moalli et al [93] investigated rat as an animal model for the structural and mechanical properties of the vagina and its supportive tissues.…”

Section: In Vivo Studiesmentioning

confidence: 99%

“…The biaxial nonlinear elastic and viscoelastic mechanical properties of the uterosacral and cardinal ligament complex were studied in the swine by Becker and De Vita [96] and Tan et al [97]. The swine ligaments were observed to undergo large biaxial deformations and to be orthotropic.…”

Section: Ex Vivo Studies the Ex Vivo Nonlinear Mechanical Propertiesmentioning

confidence: 99%

Mechanical Properties of Female Reproductive Organs and Supporting Connective Tissues: A Review of the Current State of Knowledge

Baah-Dwomoh

McGuire

Tan

et al. 2016

Applied Mechanics Reviews

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Although there has been an upsurge of interest in research on women's sexual and reproductive health, most of the research has remained confined to the obstetrics and gynecology disciplines, without knowledge flow to the biomechanics community. Thus, the mechanics of the female reproductive system and the changes determined by pregnancy, age, obesity, and various medical conditions have not been thoroughly studied. In recent years, more investigators have been focusing their efforts on evaluating the mechanical properties of the reproductive organs and supportive connective tissues, but, despite the many advances, there is still a lot that remains to be done. This paper provides an overview of the research published over the past few decades on the mechanical characterization of the primary female reproductive organs and supporting connective tissues. For each organ and tissue, after a brief description of the function and structure, the testing methods and main mechanical results are presented. Constitutive equations are then reviewed for all organs/tissues together. The goal is to spark the interest of new investigators to this largely untapped but fast-evolving branch of soft tissue mechanics that will impact women's gynecologic, reproductive, and sexual health care.

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“…47 measured the uniaxial elastic and stress relaxation response of USLs while, more recently, we characterized the elastic, stress relaxation and creep properties of the USL (and cardinal ligament) using the swine as animal model. 1,2,7,45,46 In addition to uniaxial tensile tests, 46 planar biaxial tensile tests, which better emulate the complex in vivo loading conditions of the USL, were performed. 2,7,45 …”

Section: Introductionmentioning

confidence: 99%

Mechanical Analysis of the Uterosacral Ligament: Swine vs. Human

et al. 2018

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The uterosacral ligament (USL) is a major suspensory structure of the female pelvic floor, providing support to the cervix and/or upper vagina. it plays a pivotal role in surgical procedures for pelvic organ prolapse (PoP) aimed at restoring apical support. Despite its important mechanical function, little is known about the mechanical properties of the USL due to the constraints associated with in vivo testing of human USL and the lack of validated large animal models that enable such investigations. in this study, we provide the first comparison of the mechanical properties of swine and human USLs. Preconditioning and pre-creep data up to a 2 N load and creep data under a 2 N load over 1200 s were obtained on swine (n = 9) and human (n = 9) USL specimens by performing planar equi-biaxial tensile tests and using the digital image correlation method. No differences in the peak strain during preconditioning tests, secant modulus of the pre-creep response, and strain at the end of creep tests were detected in the USLs from the two species along both axial loading directions (the main in vivo loading direction and the direction that is perpendicular to it). These findings suggest that the swine holds promise as large animal model for studying the mechanical role of the USL in apical vaginal support and treatment of PoP.

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Biaxial mechanical properties of swine uterosacral and cardinal ligaments

Cited by 26 publications

References 43 publications

What's new in the functional anatomy of pelvic organ prolapse?

What's new in the functional anatomy of pelvic organ prolapse?

Mechanical Properties of Female Reproductive Organs and Supporting Connective Tissues: A Review of the Current State of Knowledge

Mechanical Analysis of the Uterosacral Ligament: Swine vs. Human

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