Biomechanical Mapping of the Female Pelvic Floor: Prolapse versus Normal Conditions.
Biomechanical Mapping of the Female Pelvic Floor: Prolapse versus Normal Conditions.
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DOI：
10.4236/ojog.2018.810093
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发表时间：
2018-08-01
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影响因子：
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通讯作者：
van Raalte, Heather
中科院分区：
文献类型：
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作者：
Egorov, Vladimir;Shobeiri, S Abbas;van Raalte, Heather
背景：体内盆腔支持结构和功能的定量生物力学特征被认为可以深入了解盆腔器官脱垂（POP）的病理生理学。一种创新方法——阴道触觉成像——可以对女性盆底进行生物力学测绘，以量化组织弹性、盆腔支撑和盆腔肌肉功能。阴道触觉成像仪 (VTI) 记录施加组织变形和盆底肌肉收缩期间阴道壁的高清压力模式。 目的：探索一组扩展的 52 个生物力学参数，用于区分和表征 POP 相对于正常盆底状况的特征。 方法：对 96 名患有正常和 POP 状况的受试者进行了多点观察、病例对照的数据分析。 研究； 42 名受试者盆底状况正常，54 名受试者患有 POP。 VTI 型号 2S 与分析软件包一起使用，可自动计算 8 个 VTI 测试程序（探头插入、抬高、旋转、Valsalva 动作、2 个平面的随意肌收缩、放松和反射收缩）的 52 个生物力学参数。各组的受试者年龄和胎次均相等。结果：建立了所有 52 个 VTI 参数的范围、平均值和标准差。 52 个参数中的 33 个被确定为对 POP 发展具有统计敏感性（p < 0.05；t 检验）。在这 33 个参数中，11 个参数显示组织弹性的变化（下降），8 个参数显示骨盆支撑恶化，14 个参数显示 POP 与正常情况下肌肉功能的弱点。结论：女性盆底与 VTI 的生物力学映射提供了一组独特的参数来表征 POP 与正常情况。 POP 下盆腔组织、支撑结构和功能的这些客观可测量的生物力学转变可用于未来的研究和实际应用。
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.