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International Urogynecology Journal
Published in: International Urogynecology Journal 4/2014

01-04-2014 | Original Article

Calculation of membrane tension in selected sections of the pelvic floor

Authors: Yves Ozog, Jan Deprest, Kim Haest, Filip Claus, Dirk De Ridder, Edoardo Mazza

Published in: International Urogynecology Journal | Issue 4/2014

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Abstract

Introduction and hypothesis

A mathematical model to estimate membrane tensions (Mt) at the urogenital hiatus and midpelvis in patients with and without prolapse is proposed. For that purpose the complex structures of the pelvic floor were simplified and, based on assumptions concerning geometry and loading conditions, Laplace’s law was used to calculate Mt. The pelvic cavity is represented by an ellipsoid in which the midpelvic and hiatal sections are described by an ellipse. The downwards forces within the pelvis (Fin) are in equilibrium with the support forces within its walls (Fw). Fin is the abdominal pressure (PABD) multiplied by the area A of the ellipse. The force inside the tissues (Fw) is distributed along the circumference of the ellipse C. The Mt can be approximated as Mt = (PABD.A)/C (N/m). Mt-α accounts for the angle α which describes tissue orientation with respect to the anatomical section and is calculated as Mt-α = Mt/sin(α).

Methods

We conducted a retrospective study on archived magnetic resonance imaging scans (n = 20) and ultrasound images in patients with (n = 50) or without prolapse (n = 50) and measured actual geometrical variables. PABD was measured in patients with and without prolapse (n = 20).

Results

Mt at the urogenital hiatus at rest is 0.35 N/cm. They significantly increase with the Valsalva manoeuvre, by a factor of 2.3 (without prolapse) to 3.6 (with prolapse).

Conclusions

Calculated Mt are much lower than what is reported for the abdominal cavity. Prolapse patients have significantly larger Mt, which during the Valsalva manoeuvre increase more than in healthy subjects.
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Metadata
Title
Calculation of membrane tension in selected sections of the pelvic floor
Authors
Yves Ozog
Jan Deprest
Kim Haest
Filip Claus
Dirk De Ridder
Edoardo Mazza
Publication date
01-04-2014
Publisher
Springer London
Published in
International Urogynecology Journal / Issue 4/2014
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI
https://doi.org/10.1007/s00192-013-2253-1

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