UNS: Collaborative Research: Impact of Pregnancy on the Mechanics of Vaginal Tissue

UNS：合作研究：怀孕对阴道组织力学的影响

• 批准号: 1511603
• 负责人: Raffaella De Vita
• 金额: $ 25万
• 依托单位: Virginia Polytechnic Institute and State University
• 依托单位国家: 美国
• 项目类别: Standard Grant
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-08-15 至 2020-07-31
• 项目状态: 已结题
• 来源: https://www.nsf.gov/awardsearch/showAward?AWD_ID=1511603&HistoricalAwards=false
• 关键词: UNS; Collaborative; Research; Impact; Pregnancy

Pelvic floor disorders (PFDs) encompass a number of medical conditions including stress urinary and fecal incontinence, and pelvic organ prolapse. Although not often discussed, these conditions are extremely common, with more than 50% of parous women having some degree of a PFD during their lifetime and 11% of women requiring surgery. These disorders severely alter the quality of life of women often leading to isolation and depression. To someone not entirely familiar with internal female pelvic anatomy, it may appear that the vagina is no more important than the rectum or urethra in the development of these disorders. However, the vagina is the primary support structure for the urethra, bladder, uterus, and rectum. The vagina is, in turn, supported by a combination of muscle and connective tissues. A direct insult to the vagina and/or its supportive muscles and tissues compromises the function of other pelvic organs. Thus, it should come as no surprise that excessive stretching and tearing of the vagina during labor and vaginal delivery are predisposing factors for the development of PFDs. It is still unclear, however, which of the structural and mechanical alterations that occur in vaginal tissue during pregnancy predispose women to the development of PFDs. This collaborative project aims to characterize, for the first time, the mechanisms of stretch induced damage and tear propagation in virgin and pregnant rat vaginal tissue. A comprehensive set of ring tests will be conducted to determine the functional role of the tissue?s constituents (collagen, elastin, and smooth muscle cells) on both the active and passive mechanics of the vagina. Planar biaxial tests will be performed to study the tear propagation process. The results of these tests will guide the development of a new constitutive model that will capture the active and passive mechanical response of the vaginal tissue, including stretch-induced damage. The constitutive model will be implemented into a finite element code especially developed to simulate damage and tear propagation of vaginal tissue. For validation, three-dimensional in-vivo experimental data, which are collected by conducting inflation tests that simulate a birth injury within a state-of-the-art 7T micro-MRI, will be utilized.

盆底疾病 (PFD) 包括多种疾病，包括压力性尿失禁和大便失禁以及盆腔器官脱垂。虽然不常被讨论，但这些情况非常常见，超过 50% 的经产女性在其一生中患有某种程度的 PFD，11% 的女性需要手术。这些疾病严重改变了女性的生活质量，常常导致孤立和抑郁。对于不完全熟悉女性盆腔内部解剖结构的人来说，在这些疾病的发展中，阴道可能并不比直肠或尿道更重要。然而，阴道是尿道、膀胱、子宫和直肠的主要支撑结构。阴道又由肌肉和结缔组织共同支撑。对阴道和/或其支持性肌肉和组织的直接损伤会损害其他盆腔器官的功能。因此，分娩和阴道分娩过程中阴道的过度拉伸和撕裂是 PFD 发生的诱发因素也就不足为奇了。然而，目前尚不清楚怀孕期间阴道组织中发生的哪些结构和机械变化导致女性容易发生 PFD。该合作项目旨在首次表征处女和怀孕大鼠阴道组织中拉伸引起的损伤和撕裂传播的机制。将进行一套全面的环形测试，以确定组织成分（胶原蛋白、弹性蛋白和平滑肌细胞）对阴道主动和被动力学的功能作用。将进行平面双轴测试来研究撕裂传播过程。这些测试的结果将指导新的本构模型的开发，该模型将捕获阴道组织的主动和被动机械响应，包括拉伸引起的损伤。本构模型将被应用到专门开发用于模拟阴道组织损伤和撕裂传播的有限元代码中。为了进行验证，将利用三维体内实验数据，这些数据是通过在最先进的 7T 微型 MRI 中进行模拟出生伤害的充气测试来收集的。