Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment.
Biomechanical paradigm and interpretation of female pelvic floor conditions before a treatment.
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DOI：
10.2147/ijwh.s136989
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Egorov V
中科院分区：
文献类型：
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作者：
Lucente V;van Raalte H;Murphy M;Egorov V
如果骨盆底受损的病人能够接受医学成像和生物力学诊断测试，就有可能在恢复妇女健康方面取得进一步进展。这些测试的结果可能有助于分析多种治疗方案，并为患者提供最佳治疗方案。为研究女性骨盆底的阴道状况、肌肉和结缔组织的生物力学特性提供一种新的方法。阴道触觉成像（VTI）允许在静止状态下，通过手动施加偏转压力以及肌肉收缩、肌肉松弛和Valsalva动作，对沿着阴道前壁、后壁和侧壁的整个长度的软组织沿着进行生物力学评估。VTI允许进行大量测量，以评估组织弹性、支撑缺陷以及骨盆肌肉功能的个体差异。假设1）女性骨盆底器官由韧带悬挂，肌肉收缩以打开或关闭出口，2）受损的韧带削弱了支撑并可能降低肌肉收缩的力，我们试图从VTI数据中表征多个骨盆底结构。所有参加研究的138名妇女都成功地接受了VTI检查。研究受试者具有正常的盆腔支撑或盆腔器官脱垂（I-IV期）。该组受试者的平均年龄为60±15岁。我们将一组31个VTI参数转化为骨盆肌肉和韧带结构的定量表征。根据功能解剖的生物力学评估，提出了对正常盆底支持和脱垂条件下获得的VTI数据的解释。阴道触觉成像允许在体内对女性盆底结构和组织进行生物力学表征，这可能有助于优化疾病状况（例如脱垂、失禁、萎缩和某些形式的盆腔疼痛）的治疗。
Further progress in restoring a woman’s health may be possible if a patient with a damaged pelvic floor could undergo medical imaging and biomechanical diagnostic tests. The results of such tests could contribute to the analysis of multiple treatment options and suggest the optimal one for that patient. To develop a new approach for the biomechanical characterization of vaginal conditions, muscles, and connective tissues in the female pelvic floor. Vaginal tactile imaging (VTI) allows biomechanical assessment of the soft tissue along the entire length of the anterior, posterior, and lateral vaginal walls at rest, with manually applied deflection pressures and with muscle contraction, muscle relaxation, and Valsalva maneuver. VTI allows a large body of measurements to evaluate individual variations in tissue elasticity, support defects, as well as pelvic muscle function. Presuming that 1) the female pelvic floor organs are suspended by ligaments against which muscles contract to open or close the outlets and 2) damaged ligaments weaken the support and may reduce the force of muscle contraction, we made an attempt to characterize multiple pelvic floor structures from VTI data. All of the 138 women enrolled in the study were successfully examined with the VTI. The study subjects have had normal pelvic support or pelvic organ prolapse (stages I–IV). The average age of this group of subjects was 60±15 years. We transposed a set of 31 VTI parameters into a quantitative characterization of pelvic muscles and ligamentous structures. Interpretation of the acquired VTI data for normal pelvic floor support and prolapse conditions is proposed based on biomechanical assessment of the functional anatomy. Vaginal tactile imaging allows biomechanical characterization of female pelvic floor structures and tissues in vivo, which may help to optimize treatment of the diseased conditions such as prolapse, incontinence, atrophy, and some forms of pelvic pain.