Computational Analysis of Pelvic Floor Dysfunction

Bhattarai, Aroj; Frotscher, Ralf; Staat, Manfred

doi:10.1007/978-3-319-71574-2_17

Cited by 2 publications

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References 23 publications

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“…The stress-strain curves of all pelvic structures are adopted from experiments published in literature and are fitted with three-term polynomial functions ( 15 ) to obtain isotropic hyperelastic parameters which are later used for the numerical study ( Table 3 ) . Literally, it is not easy to obtain a stress-strain relation for all tissues which consider anisotropy, wherever possible, as it is rather difficult to cope up with the FE software because all anisotropic nonlinear mechanical characterization is not readily available [ 51 , 52 ]. Therefore, focus is given on the simple isotropic but widely adopted nonlinear hyperelastic material behaviour.…”

Section: Sheet Plastination To Finite Element Modelsmentioning

confidence: 99%

Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions

Bhattarai

Staat

2018

Computational and Mathematical Methods in Medicine

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After menopause, decreased levels of estrogen and progesterone remodel the collagen of the soft tissues thereby reducing their stiffness. Stress urinary incontinence is associated with involuntary urine leakage due to pathological movement of the pelvic organs resulting from lax suspension system, fasciae, and ligaments. This study compares the changes in the orientation and position of the female pelvic organs due to weakened fasciae, ligaments, and their combined laxity. A mixture theory weighted by respective volume fraction of elastin-collagen fibre compound (5%), adipose tissue (85%), and smooth muscle (5%) is adopted to characterize the mechanical behaviour of the fascia. The load carrying response (other than the functional response to the pelvic organs) of each fascia component, pelvic organs, muscles, and ligaments are assumed to be isotropic, hyperelastic, and incompressible. Finite element simulations are conducted during Valsalva manoeuvre with weakened tissues modelled by reduced tissue stiffness. A significant dislocation of the urethrovesical junction is observed due to weakness of the fascia (13.89 mm) compared to the ligaments (5.47 mm). The dynamics of the pelvic floor observed in this study during Valsalva manoeuvre is associated with urethral-bladder hypermobility, greater levator plate angulation, and positive Q-tip test which are observed in incontinent females.

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Section: Sheet Plastination To Finite Element Modelsmentioning

confidence: 99%

Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions

Bhattarai

Staat

2018

Computational and Mathematical Methods in Medicine

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Surgical treatment of vaginal vault prolapse using different prosthetic mesh implants: a finite element analysis

Bhattarai

Jabbari

Anding

et al. 2018

Tm - Technisches Messen

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Particularly multiparous elderly women may suffer from vaginal vault prolapse after hysterectomy due to weak support from lax apical ligaments. A decreased amount of estrogen and progesterone in older age is assumed to remodel the collagen thereby reducing tissue stiffness. Sacrocolpopexy is either performed as open or laparoscopic surgery using prosthetic mesh implants to substitute lax ligaments. Y-shaped mesh models (DynaMesh, Gynemesh, and Ultrapro) are implanted in a 3D female pelvic floor finite element model in the extraperitoneal space from the vaginal cuff to the first sacral (S1) bone below promontory. Numerical simulations are conducted during Valsalva maneuver with weakened tissues modeled by reduced tissue stiffness. Tissues are modeled as incompressible, isotropic hyperelastic materials whereas the meshes are modeled either as orthotropic linear elastic or as isotropic hyperlastic materials. The positions of the vaginal cuff and the bladder base are calculated from the pubococcygeal line for female pelvic floor at rest, for prolapse and after repair using the three meshes. Due to mesh mechanics and mesh pore deformation along the loaded direction, the DynaMesh with regular rectangular mesh pores is found to provide better mechanical support to the organs than the Gynemesh and the Ultrapro with irregular hexagonal mesh pores.

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Computational Analysis of Pelvic Floor Dysfunction

Cited by 2 publications

References 23 publications

Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions

Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions

Surgical treatment of vaginal vault prolapse using different prosthetic mesh implants: a finite element analysis

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