TITLE:
Biomechanical Mapping of the Female Pelvic Floor: Prolapse versus Normal Conditions
AUTHORS:
Vladimir Egorov, S. Abbas Shobeiri, Peter Takacs, Lennox Hoyte, Vincent Lucente, Heather van Raalte
KEYWORDS:
Biomechanical Mapping, Female Pelvic Floor, Prolapse, Tissue Elasticity, Pelvic Support, Pelvic Function, Tactile Imaging, Elastography
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.8 No.10,
August
31,
2018
ABSTRACT: Background: Quantitative biomechanical characterization of pelvic supportive
structures and functions in vivo is
thought to provide insight into pathophysiology of pelvic organ prolapse (POP).
An innovative approach—vaginal tactile imaging—allows biomechanical mapping of
the female pelvic floor to quantify tissue elasticity, pelvic support, and
pelvic muscle functions. The Vaginal Tactile Imager (VTI) records high
definition pressure patterns from vaginal walls under an applied tissue
deformation and during pelvic floor muscle contractions. Objective: To
explore an extended set of 52 biomechanical parameters for differentiation and
characterization of POP relative to normal pelvic floor conditions. Methods: 96 subjects with normal and POP conditions were included in the data analysis
from multi-site observational, case-controlled studies; 42 subjects had normal
pelvic floor conditions and 54 subjects had POP. The VTI, model 2S, was used
with an analytical software package to calculate automatically 52 biomechanical
parameters for 8 VTI test procedures (probe insertion, elevation, rotation,
Valsalva maneuver, voluntary muscle contractions in 2 planes, relaxation, and
reflex contraction). The groups were equalized for subject age and parity. Results: The ranges, mean values, and standard deviations for all 52 VTI parameters were
established. 33 of 52 parameters were identified as statistically sensitive (p 0.05; t-test) to the POP
development. Among these 33 parameters, 11 parameters show changes (decrease)
in tissue elasticity, 8 parameters show deteriorations in pelvic support and 14
parameters show weakness in muscle functions for POP versus normal conditions. Conclusions: The biomechanical
mapping of the female pelvic floor with the VTI provides a unique set of parameters
characterizing POP versus normal
conditions. These objectively measurable biomechanical transformations of
pelvic tissues, support structures, and functions under POP may be used in
future research and practical applications.