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首页> 外文期刊>Neurourology and urodynamics. >Three‐dimensional finite element analysis of the pelvic organ prolapse: A parametric biomechanical modeling
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Three‐dimensional finite element analysis of the pelvic organ prolapse: A parametric biomechanical modeling

机译：骨盆器官脱垂的三维有限元分析：参数化生物力学建模

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摘要

Aims To evaluate the role of soft tissue and ligaments damage and level of pelvic muscles activation versus intra‐abdominal pressure, on pelvic organ prolapse. Methods This was a computational modeling based on the finite element analysis. Three pelvic muscles, four pelvic ligaments, and three organs (urethra, vagina, and rectum) were simulated. The model was subjected to total 41?472 analysis cases including three intra‐abdominal pressures, two damaging levels for the ligaments, three damaging levels for the muscles, and four intentional levels of activation for muscles. Results Increased intra‐abdominal pressures caused significant statistical increase of the pelvic organ prolapse ( P ?=?0.000) up to 10?mm downward. Ligaments’ defect had no statistically‐significant effect on prolapse of the organs ( P ?=?0.981 for rectum, P ?=?0.423 for urethra, and P ?=?0.752 for vagina). Damage in the pelvic floor muscles and low intentional level of activation also deteriorated the prolapse ( P ?=?0.000). Conclusion Increase of the intra‐abdominal pressure (IAP) as may be existed during pregnancy or physical activity increased the organ prolapse. Damages of the ligaments caused less effects on the prolapse. Loss of the passive properties of the muscles which is probable after delivery or aging moderately deteriorated the prolapse disorder. However, activation of the pelvic floor muscles prevented the prolapse. Different recruitments of the muscles, specifically the pubococcygeus (PCM), could compensate the possible defects in other tissues. Targeted pelvic floor muscle training (PFMT) could also be effective in older adults due to considerable role of the pelvic muscles’ intentional activation.
机译：旨在评估软组织和韧带损伤和盆腔肌肉激活水平对腹腔内压力的作用，对盆腔器官脱垂。方法这是基于有限元分析的计算建模。模拟了三种盆腔肌肉，四个骨盆韧带和三个器官（尿道，阴道和直肠）。该模型进行了总共41〜472分析案例，包括腹部内压，韧带的两个破坏性水平，肌肉的三种破坏水平，肌肉的四种故意活化水平。结果腹内压力升高增加骨盆器官脱垂（P≤X≤0.000）的显着统计增加，向下高达10Ωmm。韧带的缺陷对器官的脱垂没有统计学显着的影响（p？=β= 0.981，p？=尿道0.423，p？=β= 0.752用于阴道）。骨盆底部肌肉损伤和低故意活化水平也恶化了（p？= 0.000）。结论腹内压力（IAP）的增加，妊娠期间可能存在，或体育活动增加了器官脱垂。韧带的损伤导致对脱垂的影响较少。损失肌肉的被动性质可能在递送或老化后中度恶化脱垂障碍。然而，激活盆底肌肉阻止脱垂。肌肉的不同招募，特别是寄宿寄生虫（PCM），可以补偿其他组织中可能的缺陷。由于骨盆肌肉的故意激活，目标骨盆底肌训练（PFMT）也可能在老年人中有效。

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