TY - JOUR
T1 - Viscoelastic properties measurement of the prolapsed anterior vaginal wall
T2 - A patient-directed methodology
AU - Chuong, Cheng Jen
AU - Ma, Milton
AU - Eberhart, Robert C.
AU - Zimmern, Philippe
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2014/2
Y1 - 2014/2
N2 - Objective In-vivo measurement of the viscoelastic properties of the prolapsed anterior vaginal wall (AVW) in post-menopausal women undergoing cystocele repair. Study design A BTC-2000™ cutometer-like instrument was introduced during vaginal repair of symptomatic stage 2-3 AVW prolapse. Under anesthesia, 10-mm orifice probe was applied to the AVW at the level of the bladder neck. A suction pressure ramp (0 to -147 mmHg in 6 s) was delivered causing tissue uplift, followed by immediate release to 0 mmHg, measuring tissue relaxation for 20 s. Similar measurements were performed over the suprapubic region (SP) for comparison purpose. The rate of tissue recovery was obtained by fitting a Voigt model to the data and expressing results as the ratio E/η [(spring modulus E)/(dashpot viscosity η)]. The effective strain energy (SE) was calculated from the pressure-uplift data and evaluated from initiation to: (1) maximum storage in tissue at peak vacuum; (2) tissue recovery after vacuum release; (3) net SE loss over the entire loading-unloading cycle. Results In 22 women, higher AVW peak and residual tissue uplift values, and lower E/η ratios were found compared with SP results. The AVW stored less elastic strain energy at peak vacuum than did the SP, and AVW net energy loss over the uplift-recovery cycle was greater than for SP controls. Not only was the AVW more compliant than the SP, with higher viscous damping, but the tissue was also less able to store recoverable energy upon distension. Conclusion Such in-vivo measurements quantify the biomechanical properties of the prolapsed AVW and may assist in its management.
AB - Objective In-vivo measurement of the viscoelastic properties of the prolapsed anterior vaginal wall (AVW) in post-menopausal women undergoing cystocele repair. Study design A BTC-2000™ cutometer-like instrument was introduced during vaginal repair of symptomatic stage 2-3 AVW prolapse. Under anesthesia, 10-mm orifice probe was applied to the AVW at the level of the bladder neck. A suction pressure ramp (0 to -147 mmHg in 6 s) was delivered causing tissue uplift, followed by immediate release to 0 mmHg, measuring tissue relaxation for 20 s. Similar measurements were performed over the suprapubic region (SP) for comparison purpose. The rate of tissue recovery was obtained by fitting a Voigt model to the data and expressing results as the ratio E/η [(spring modulus E)/(dashpot viscosity η)]. The effective strain energy (SE) was calculated from the pressure-uplift data and evaluated from initiation to: (1) maximum storage in tissue at peak vacuum; (2) tissue recovery after vacuum release; (3) net SE loss over the entire loading-unloading cycle. Results In 22 women, higher AVW peak and residual tissue uplift values, and lower E/η ratios were found compared with SP results. The AVW stored less elastic strain energy at peak vacuum than did the SP, and AVW net energy loss over the uplift-recovery cycle was greater than for SP controls. Not only was the AVW more compliant than the SP, with higher viscous damping, but the tissue was also less able to store recoverable energy upon distension. Conclusion Such in-vivo measurements quantify the biomechanical properties of the prolapsed AVW and may assist in its management.
KW - Pelvic organ prolapse
KW - Tissue viscoelastic properties
KW - Vaginal biomechanics
KW - Voigt model
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U2 - 10.1016/j.ejogrb.2013.11.012
DO - 10.1016/j.ejogrb.2013.11.012
M3 - Article
C2 - 24331114
AN - SCOPUS:84893668348
SN - 0301-2115
VL - 173
SP - 106
EP - 112
JO - European Journal of Obstetrics and Gynecology and Reproductive Biology
JF - European Journal of Obstetrics and Gynecology and Reproductive Biology
IS - 1
ER -