Biomechanical study on the bladder neck and urethral positions: simulation of impairment of the pelvic ligaments.

摘要: Excessive mobility of the bladder neck and urethra are common features in stress urinary incontinence. We aimed at assessing, through computational modelling, position taking into account progressive impairment pelvic ligaments. Magnetic resonance images a young healthy female were used to build model cavity. Appropriate material properties constitutive models defined. The ligaments was simulated by mimicking reduction their stiffness. For ligaments, valsalva maneuver led an increase α angle (between neck-symphysis pubis main symphysis) from 91.8° (at rest) 105.7°, 5.7 mm dislocation, which similar dynamic imaging same woman (α 80° 103.3°, 5mm movement). 95% impairment, they enlarged 124.28° 12 mm. Impairment pubourethral had higher effect than that vaginal support (115° vs. 108°, 9.1 7.3mm). Numerical simulation could predict urethral motion during maneuver, for both impaired Results those continent women with incontinence published literature. Biomechanical analysis complements biomechanical study cavity It may be useful presenting without evidence muscle lesions or organ descend valsalva, whom fascial damage not expected.