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Biomechanical properties vagina

Robert Eberhart, Cheng-Jen Chuong, Philippe Zimmern
AIMS: To critically review studies of the biomechanical properties of connective tissue in the normal and prolapsed human vaginal wall and to identify criteria that are suitable for in vivo measurements which could improve patient management. METHODS: This review covers past and current ex vivo and in vivo instrumentation and analytical methods related to the elastic and viscoelastic properties of vaginal wall connective tissues. RESULTS: Classical methods, including digital evaluation of the vagina, histological and biomechanical studies of fresh and frozen-thawed extracts, and biomechanical cadaveric tissue studies have important limitations and have yielded inconsistent results...
February 1, 2016: Neurourology and Urodynamics
Rui Liang, Katrina Knight, Alexis Nolfi, Steven Abramowitch, Pamela A Moalli
OBJECTIVE: Some selective estrogen receptor modulators (SERMs) have been associated with increased incidence of urinary incontinence and pelvic organ prolapse. This study explored the effects of five SERMs on the function and matrix components of the vagina and its supportive tissues. METHODS: Fifty-six rats were administered SERMs by oral gavage for 8 weeks (n = 8 for each SERM): raloxifene, tamoxifen, idoxifene, bazedoxifene at three different doses, and bazedoxifene with conjugated estrogens...
February 2016: Menopause: the Journal of the North American Menopause Society
Daniela Ulrich, Sharon L Edwards, David L J Alexander, Anna Rosamilia, Jerome A Werkmeister, Caroline E Gargett, Vincent Letouzey
BACKGROUND: Pelvic organ prolapse (POP) is a multifactorial disease that manifests as the herniation of the pelvic organs into the vagina. Surgical methods for prolapse repair involve the use of a synthetic polypropylene mesh. The use of this mesh has led to significantly higher anatomical success rates compared with native tissue repairs, and therefore, despite recent warnings by the Food and Drug Administration regarding the use of vaginal mesh, the number of POP mesh surgeries has increased over the last few years...
February 2016: American Journal of Obstetrics and Gynecology
Masayuki Endo, Iva Urbankova, Jaromir Vlacil, Siddarth Sengupta, Thomas Deprest, Bernd Klosterhalfen, Andrew Feola, Jan Deprest
The properties of meshes used in reconstructive surgery affect the host response and biomechanical characteristics of the grafted tissue. Whereas durable synthetics induce a chronic inflammation, biological grafts are usually considered as more biocompatible. The location of implantation is another determinant of the host response: the vagina is a different environment with specific function and anatomy. Herein, we evaluated a cross-linked acellular collagen matrix (ACM), pretreated by the anti-calcification procedure ADAPT® in a sheep model for vaginal surgery...
2015: Gynecological Surgery
Daniela Ulrich, Sharon L Edwards, Vincent Letouzey, Kai Su, Jacinta F White, Anna Rosamilia, Caroline E Gargett, Jerome A Werkmeister
OBJECTIVE: There are increasing numbers of reports describing human vaginal tissue composition in women with and without pelvic organ prolapse with conflicting results. The aim of this study was to compare ovine and human posterior vaginal tissue in terms of histological and biochemical tissue composition and to assess passive biomechanical properties of ovine vagina to further characterise this animal model for pelvic organ prolapse research. STUDY DESIGN: Vaginal tissue was collected from ovariectomised sheep (n = 6) and from postmenopausal women (n = 7) from the proximal, middle and distal thirds...
2014: PloS One
Daniela Ulrich, Sharon L Edwards, Kai Su, Jacinta F White, John A M Ramshaw, Graham Jenkin, Jan Deprest, Anna Rosamilia, Jerome A Werkmeister, Caroline E Gargett
OBJECTIVE: To undertake a comprehensive analysis of the biochemical tissue composition and passive biomechanical properties of ovine vagina and relate this to the histo-architecture at different reproductive stages as part of the establishment of a large preclinical animal model for evaluating regenerative medicine approaches for surgical treatment of pelvic organ prolapse. METHODS: Vaginal tissue was collected from virgin (n = 3), parous (n = 6) and pregnant sheep (n = 6; mean gestation; 132 d; term = 145 d)...
2014: PloS One
Andrew Feola, Masayuki Endo, Jan Deprest
INTRODUCTION AND HYPOTHESIS: The vagina and surrounding structures have been shown to remodel during pregnancy. Our objective was to characterize the biomechanical properties of the vagina in the rodent model in vivo utilizing three-dimensional (3D) ultrasound. METHODS: The vagina was visualized by ultrasound after distention by increasing pressures throughout pregnancy (15 and 18 days) and after vaginal delivery (7 and 30 days postpartum) of six longitudinally followed rodents...
July 2014: International Urogynecology Journal
Xuemei Fan, Yanzhou Wang, Yu Wang, Huicheng Xu
INTRODUCTION AND HYPOTHESES: Our aim was to compare histological and biomechanical effects of polypropylene (PP) mesh and porcine-derived, cross-linked urinary bladder matrix (cUBM) graft materials using a rabbit vaginal and abdominal model. METHODS: Forty rabbits were implanted with PP mesh (n = 20) or cUBM (n = 20) in the vagina and abdomen. Two grafts (PP or cUBM) of the same type were placed into each site, so each rabbit had four grafts. Grafts were harvested 12 weeks later and processed for histologic analysis and biomechanical testing...
May 2014: International Urogynecology Journal
Sunil Balgobin, T Ignacio Montoya, Haolin Shi, Jesus F Acevedo, Patrick W Keller, Matthew Riegel, Clifford Y Wai, Ruth Ann Word
Loss of pelvic organ support (i.e., pelvic organ prolapse) is common in menopausal women. Surgical reconstruction of pelvic organ prolapse is plagued with high failure rates. The objective of this study was to determine the effects of estrogen on biomechanical properties, lysyl oxidase (LOX), collagen content, and histomorphology of the vagina with or without surgical injury. Nulliparous ovariectomized guinea pigs were treated systemically with either 50 μg/kg/day estradiol (E2,) or vehicle. After 2 wk, vaginal surgery was performed, and animals were treated with either beta-aminopropionitrile (BAPN, an irreversible LOX inhibitor), or vehicle to determine the role of LOX in recovery of the vaginal wall from injury with or without E2...
December 2013: Biology of Reproduction
Pedro Martins, Agnaldo Lopes Silva-Filho, Andrea Moura Rodrigues Maciel da Fonseca, Agostinho Santos, Liliana Santos, Teresa Mascarenhas, Renato M Natal Jorge, António J M Ferreira
BACKGROUND/AIMS: To compare biomechanical properties of vaginal tissues between women with and without pelvic organ prolapse (POP) and investigate factors that may influence these properties. METHODS: Forty patients submitted to POP surgery and 15 non-POP cadavers were evaluated. The tissue was excised from anterior and posterior middle third vagina. The biomechanical properties considered were stiffness (E) and maximum stress (S), and they were evaluated by means of uniaxial tension tests...
2013: Gynecologic and Obstetric Investigation
S Manodoro, M Endo, P Uvin, M Albersen, J Vláčil, A Engels, B Schmidt, D De Ridder, A Feola, J Deprest
OBJECTIVE: To compare the occurrence of graft-related complications (GRCs) and biomechanical properties of meshes implanted vaginally and abdominally. DESIGN: In vivo animal experiment. SETTING: Centre for Surgical Technologies, Medical Faculty, KU Leuven, Belgium. POPULATION: Twenty adult parous Texel ewes. METHODS: Sheep were implanted with Gynemesh M, a 28-g/m² polypropylene mesh reinforced with polyglecaprone fibres, under general anaesthesia...
January 2013: BJOG: An International Journal of Obstetrics and Gynaecology
A Feola, S Abramowitch, Z Jallah, S Stein, W Barone, S Palcsey, P Moalli
OBJECTIVE: To define the impact of prolapse mesh on the biomechanical properties of the vagina by comparing the prototype Gynemesh PS (Ethicon) to two new-generation lower stiffness meshes, SmartMesh (Coloplast) and UltraPro (Ethicon). DESIGN: A study employing a nonhuman primate model. SETTING: University of Pittsburgh, PA, USA. POPULATION: Forty-five parous rhesus macaques. METHODS: Meshes were implanted via sacrocolpopexy after hysterectomy and compared with sham...
January 2013: BJOG: An International Journal of Obstetrics and Gynaecology
Andrew Feola, Robert Duerr, Pamela Moalli, Steven Abramowitch
INTRODUCTION AND HYPOTHESIS: Pelvic organ prolapse is a common condition impacting the quality of life of millions of women worldwide. Although vaginal estrogen is widely used in women with prolapse, little is known regarding estrogen's benefits on the biomechanical properties of vaginal tissue. Here, we aimed to examine the effect of prolapse on the biomechanical properties of the vagina and determine alterations in vaginal mechanics in the presence and absence of hormone therapy (HT)...
July 2013: International Urogynecology Journal
Daniela Ulrich, Sharon L Edwards, Jacinta F White, Tommy Supit, John A M Ramshaw, Camden Lo, Anna Rosamilia, Jerome A Werkmeister, Caroline E Gargett
INTRODUCTION: Fascial defects are a common problem in the abdominal wall and in the vagina leading to hernia or pelvic organ prolapse that requires mesh enhancement to reduce operation failure. However, the long-term outcome of synthetic mesh surgery may be unsatisfactory due to post-surgical complications. We hypothesized that mesh fabricated from alternative synthetic polymers may evoke a different tissue response, and provide more appropriate mechanical properties for hernia repair...
2012: PloS One
Yves Ozog, Edoardo Mazza, Dirk De Ridder, Jan Deprest
INTRODUCTION AND HYPOTHESIS: To investigate the biomechanical effects of polyglecaprone fibers in lightweight meshes implanted into the vaginal and abdominal wall of parous rabbits. METHODS: New Zealand White rabbits (n = 24) were implanted with polypropylene meshes (32 g/m(2)), with (Prolift plus M, n = 12) or without (Prolift minus M, n = 12) polyglecaprone fibers. Following implantation in the posterior vaginal and abdominal wall, local side effects were evaluated and explants underwent uniaxial tensiometry after 120 and 180 days...
October 2012: International Urogynecology Journal
Chrystèle Rubod, Mathias Brieu, Michel Cosson, Géraldine Rivaux, Jean-Charles Clay, Laurent de Landsheere, Boris Gabriel
OBJECTIVE: To comparatively define the biomechanical characteristics of the pelvic organs (the vagina, bladder, and rectum), which are crucial for the maintenance of pelvic support. Despite minimal fundamental studies, meshes are increasingly implanted into the vesicovaginal and rectovaginal spaces to replace disrupted native tissues and to treat pelvic organ prolapse. However, the mechanical characteristics of these materials have not yet been compared with those of the "functional unit," the vagina, bladder, and rectum...
April 2012: Urology
Indumathi Sridharan, Yin Ma, Taeyoung Kim, William Kobak, Jacob Rotmensch, Rong Wang
Collagen, an ubiquitous biomaterial, confers robustness and resilience to connective tissues. In this study, we analyzed the structure and elasticity profile of collagen from the vaginal wall connective tissue of healthy pre-menopausal (pre-M) and postmenopausal (post-M) women. The histological staining assisted study with an atomic force microscope renders the examination of native collagen fibers on site of the connective tissue from nanoscopic scale to microscopic scale with high spatial resolution. Our results suggest that during menopause, collagen's structure and elasticity are subject to changes at all levels of organization- between individual collagen fibers, between collagen and muscle, and between collagen and other matrix elements...
February 2012: Biomaterials
Shin Hasegawa, Yuki Yoshida, Daming Wei, Sadao Omata, Christos E Constantinou
We simulated the way that pelvic floor muscles (PFM) generate zonal compression on the vagina and urethra in order to maintain urinary continence. Raw data were obtained using a probe to map the distribution of vaginal closure forces. Simulation model was made using ordinary Spring-mass model. The biomechanical properties are applied to the spring of the model. We simulated four models that are applied to asymptomatic subjects as controls and patients based on information obtained from the measured force maps using a vaginal probe...
2011: Studies in Health Technology and Informatics
E Peña, P Martins, T Mascarenhas, R M Natal Jorge, A Ferreira, M Doblaré, B Calvo
The mechanical properties of vaginal tissue need to be characterized to perform accurate simulations of prolapse and other pelvic disorders that commonly affect women. This is also a fundamental step towards the improvement of therapeutic techniques such as surgery. In this paper, the softening behavior or Mullins effect of vaginal tissue is studied by proposing an appropriate constitutive model. This effect is an important factor after the birth, since vaginal tissue has been supporting a high load distribution and therefore does not recover its original behavior...
April 2011: Journal of the Mechanical Behavior of Biomedical Materials
Pedro A L S Martins, Renato M Natal Jorge, António J M Ferreia, Cristina S Saleme, Thuane Roza, Marco M P Parente, Marcos Pinotti, Teresa Mascarenhas, Agostinho Santos, Liliana Santos, Agnaldo L Silva-Filho
BACKGROUND/AIMS: This study aims to evaluate the pelvic floor (PF) tension response during simulated increased intra-abdominal pressure (IAP) and the vaginal biomechanical properties. METHODS: A 3-dimensional computational finite element model for PF was developed based on magnetic resonance imaging from a nulliparous healthy volunteer. The model was used to simulate an IAP of 90 cm H(2)O and to evaluate the PF stresses in the longitudinal and transversal axes. The vaginal samples were obtained from 15 non-prolapsed female cadavers...
2011: Gynecologic and Obstetric Investigation
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