Strength of round and uterosacral ligaments: a biomechanical study

Martins, Pedro; Silva-Filho, Agnaldo L.; Fonseca, Adelaida Pallavicini; Santos, Agostinho; Santos, Liliana; Mascarenhas, Teresa; Jorge, R.M. Natal; Ferreira, A.J.M.

doi:10.1007/s00404-012-2564-3

Cited by 35 publications

(26 citation statements)

References 25 publications

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“…Despite the limitations in the strain measurement (i.e, use of grip-to-grip displacement and engineering strain), the experimental study by Martins et al (2013) confirms the earlier findings by Vardy et al (2005) showing that the USL undergoes large deformations. However, the mechanical properties of the CL and USL should be determined by using a planar biaxial testing system together with accurate strain measurement techniques, as done for other soft tissues (Harris et al 2003;Wells et al 2005;Grashow et al 2006;Nagatomi et al 2008;Zou and Zhang 2011), in order to better emulate their complex in vivo loading conditions.…”

Section: Introductionsupporting

confidence: 87%

“…Tensile properties, such as elastic modulus and ultimate tensile strength, of the USL in female cadavers have been quantified only recently (Martins et al 2013). Despite the limitations in the strain measurement (i.e, use of grip-to-grip displacement and engineering strain), the experimental study by Martins et al (2013) confirms the earlier findings by Vardy et al (2005) showing that the USL undergoes large deformations.…”

Section: Introductionsupporting

confidence: 71%

“…To date, there are no experimental studies on the mechanical properties of the CL, and only a few have described the uniaxial mechanical properties of the USL (Vardy et al 2005;Shahryarinejad et al 2010;Martins et al 2013). The viscoelastic behavior of the USL has been characterized in the cynomolgus monkey (Macaca fascicularis) via incremental relaxation tests (Vardy et al 2005;Shahryarinejad et al 2010).…”

Section: Introductionmentioning

confidence: 99%

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Biaxial mechanical properties of swine uterosacral and cardinal ligaments

Becker

Vita

2014

Biomech Model Mechanobiol

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Mechanical alterations to pelvic floor ligaments may contribute to the development and progression of pelvic floor disorders. In this study, the first biaxial elastic and viscoelastic properties were determined for uterosacral ligament (USL) and cardinal ligament (CL) complexes harvested from adult female swine. Biaxial stress-stretch data revealed that the ligaments undergo large strains. They are orthotropic, being typically stiffer along their main physiological loading direction (i.e., normal to the upper vaginal wall). Biaxial stress relaxation data showed that the ligaments relax equally in both loading directions and more when they are less stretched. In order to describe the experimental findings, a three-dimensional constitutive law based on the Pipkin-Rogers integral series was formulated. The model accounts for incompressibility, large deformations, nonlinear elasticity, orthotropy, and stretch-dependent stress relaxation. This combined theoretical and experimental study provides new knowledge about the mechanical properties of USLs and CLs that could lead to the development of new preventive and treatment methods for pelvic floor disorders.

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Section: Introductionsupporting

confidence: 87%

Section: Introductionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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Biaxial mechanical properties of swine uterosacral and cardinal ligaments

Becker

Vita

2014

Biomech Model Mechanobiol

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“…37,46,47 In the study by Vardy et al ., 47 elastic moduli of postmenopausal monkey USLs were determined at different strain levels from incremental pre-relaxation stress-strain curves, reaching a value of 1.00 MPa at 30% strain. By testing USLs up to failure, Martins et al .…”

Section: Discussionmentioning

confidence: 99%

“…13,37,41,42 In these studies, mechanical data were collected either using cadaveric tissue or fresh tissue collected from women undergoing hysterectomy. The measured mechanical properties were thus inevitably affected by the medical history, age, and parity of the donor/patient.…”

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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Quantifying Cell‐Derived Changes in Collagen Synthesis, Alignment, and Mechanics in a 3D Connective Tissue Model

et al. 2022

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Dysregulation of extracellular matrix (ECM) synthesis, organization, and mechanics are hallmark features of diseases like fibrosis and cancer. However, most in vitro models fail to recapitulate the three-dimensional (3D) multi-scale hierarchical architecture of collagen-rich tissues and as a result, are unable to mirror native or disease phenotypes. Herein, using primary human fibroblasts seeded into custom fabricated 3D non-adhesive agarose molds, a novel strategy is proposed to direct the morphogenesis of engineered 3D ring-shaped tissue constructs with tensile and histological properties that recapitulate key features of fibrous connective tissue. To characterize the shift from monodispersed cells to a highly-aligned, collagen-rich matrix, a multi-modal approach integrating histology, multiphoton second-harmonic generation, and electron microscopy is employed. Structural changes in collagen synthesis and alignment are then mapped to functional differences in tissue mechanics and total collagen content. Due to the absence of an exogenously added scaffolding material, this model enables the direct quantification of cell-derived changes in 3D matrix synthesis, alignment, and mechanics in response to the addition or removal of relevant biomolecular perturbations. To illustrate this, the effects of nutrient composition, fetal bovine serum, rho-kinase inhibitor, and pro-and anti-fibrotic compounds on ECM synthesis, 3D collagen architecture, and mechanophenotype are quantified.

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Strength of round and uterosacral ligaments: a biomechanical study

Abstract: The uterosacral ligaments are significantly more resistant than round ligaments. Parturition seems to enhance the stiffness and maximum stress of the ligaments.

Cited by 35 publications

References 25 publications

Biaxial mechanical properties of swine uterosacral and cardinal ligaments

Biaxial mechanical properties of swine uterosacral and cardinal ligaments

Mechanical Analysis of the Uterosacral Ligament: Swine vs. Human

Quantifying Cell‐Derived Changes in Collagen Synthesis, Alignment, and Mechanics in a 3D Connective Tissue Model

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