Tactile Imaging Markers to Characterize Female Pelvic Floor Conditions

Abstract

The Vaginal Tactile Imager (VTI) records pressure patterns from vaginal walls under an applied tissue deformation and during pelvic floor muscle contractions. The objective of this study is to validate tactile imaging and muscle contraction parameters (markers) sensitive to the female pelvic floor conditions. Twenty-two women with normal and prolapse conditions were examined by a vaginal tactile imaging probe. We identified 9 parameters which were sensitive to prolapse conditions (p < 0.05 for one-way ANOVA and/or p < 0.05 for t-test with correlation factor r from −0.73 to −0.56). The list of parameters includes pressure, pressure gradient and dynamic pressure response during muscle contraction at identified locations. These parameters may be used for biomechanical characterization of female pelvic floor conditions to support an effective management of pelvic floor prolapse.

Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment

“…These test results correlate with the pelvic floor conditions, demonstrating pressure as well as gradient decreases from normal to prolapse Stage III conditions. 27 , 33 , 34 The VTI enables quantification of the vaginal tissue elasticity and the strong differentiation between normal, Stage II, and Stage III prolapse conditions. The overlap in tissue elasticity and pelvic floor support between normal and Stage I prolapse conditions means that 1) some cases under Stage I prolapse show the same values as in normal conditions or 2) the normal case, as defined by the POP-Q system, with lower pressure feedbacks and gradients, is already in the range of Stage I prolapse.…”

“…We found the pressure maximum at both sides ( P max ), as shown in Figure 9 , correlated with the pelvic floor conditions, demonstrating P max decrease from normal to prolapse conditions. 27 Pelvic floor reconstructive surgery may also change the tactile image of this test at the affected locations.…”

Automated real-time correction of intraoperative medical tactile images: sensitivity adjustment and suppression of contact angle artifact

“…The reason is that only recently medical devices capable of registering tactile images appeared. For certain specialized diagnostic devices, such as the Breast Mechanical Imager (BMI) [8], the Prostate Mechanical Imaging system (PMI) [15], or the Vaginal Tactile Imager (VMI) [12], the required mathematical methods have already been developed and implemented in software [7], [8], [9]. However, these methods are inapplicable to tactile images produced by the Medical Tactile Endosurgical Complex (MTEC) [3].…”

Análise da distribuição multivetorial de cargas do assoalho pélvico feminino em diferentes populações

“…Among clinicians, the most typical method for quantification of PF function is digital palpation because it is fast, requires no equipment, and selectively depicts PFM activity better than most available biofeedback devices (Peschers et al 2001b Several manometers van Raalte and Egorov 2015;Ribeiro et al 2016), dynamometers (Dumoulin et al 2004a;Saleme et al 2009;Chamochumbi et al 2012;Romero-Cullerés et al 2017) and EMG techniques Ptaszkowski et al 2015) have been proposed to objectively quantify PF function. However, most of these methods were developed for research purposes, in contrast to the proposed sensor, which is already commercially available and has the advantage of differentiate the effects of maximum contraction of PFMs as opposed to an increase in intra-abdominal pressure (Valsalva) along the vaginal canal (Fig.3).…”

“…Recently, new equipment has emerged, such as a pressure sensor developed by van Raalte and Egorov (2015) to record tissue deformation patterns from the vaginal walls. However, it does not cover the entire vaginal canal, the resulting pressure maps are merely tactile images (a translation of the digital sensation of touch in to a digital image), and it is necessary to rotate the probe to get spatial pressure distribution; therefore, one cannot measure spatial and time distribution simultaneously, reducing repeatability.…”