Age-associated changes in the mechanical properties of human cadaveric pelvic floor muscles

An analysis of the muscle mechanical properties (MMPs) of the pelvic floor muscles (PFMs) is relevant for understanding the physiopathology of urinary incontinence (UI). However, there is no objective and reliable methodology currently available for quantifying the MMPs of PFMs. Thus, the objective was to determine the intra-rater and inter-rater reliability of the MMPs of PFM assessment with a hand-held tonometer device, called the MyotonPRO, in young women with and without UI. Sociodemographic and pelvic floor questionnaires, plus MMPs of PFMs were assessed in 38 nulliparous women with UI and 40 matched healthy women by two trained physiotherapists on two different occasions, 48–72 h apart. Good to excellent absolute reliability was found for tone, stiffness, and decrement of both intra- and inter-rater analyses in both study groups (Intraclass Correlation Coefficient ranged from 0.75 to 0.92), with a trend of lower values for relaxation and creep. The standard error of measurement (SEM) did not achieve 10% of the mean values for any MMPs. The minimum detectable change (MDC) values were also provided for clinical applications. In conclusion, the relative reliability of tone, stiffness, and the assessment of the decrement of PFMs with MyotonPRO is good to excellent for UI and healthy women. The SEM and MDC values were acceptable for their application in clinical settings.

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Faculty Opinions recommendation of Electrospun matrices for pelvic floor repair: effect of fiber diameter on mechanical properties and cell behavior.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.726781354.793560587 ◽

2019 ◽

Author(s):

Christopher Chapple

Keyword(s):

Mechanical Properties ◽

Pelvic Floor ◽

Fiber Diameter ◽

Cell Behavior ◽

Pelvic Floor Repair

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Faculty Opinions recommendation of Neural control of the female urethral and anal rhabdosphincters and pelvic floor muscles.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8136970.8536081 ◽

2011 ◽

Author(s):

Wilfrid Jänig

Keyword(s):

Pelvic Floor ◽

Neural Control ◽

Pelvic Floor Muscles

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Episiotomy: the biomechanical impact of multiple small incisions during a normal vaginal delivery

Interface Focus ◽

10.1098/rsfs.2019.0027 ◽

2019 ◽

Vol 9 (5) ◽

pp. 20190027 ◽

Cited By ~ 1

Author(s):

Dulce Oliveira ◽

Maria Vila Pouca ◽

João Ferreira ◽

Teresa Mascarenhas

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Levator Ani ◽

Symphysis Pubis ◽

Pelvic Floor Muscles ◽

Point Of View ◽

Normal Vaginal Delivery ◽

Tissue Integrity ◽

Levator Trauma ◽

Reaction Forces

Childbirth-related injuries are one of the main causes of pelvic floor dysfunction. To attempt to avoid serious tears during delivery, an episiotomy can be performed. In this study, we intended to investigate the biomechanical performance of the pelvic floor muscles after performing different episiotomies using a physics-based computational model which includes the pelvic floor muscles and the fetus. Previous biomechanical studies have analysed the mechanical effects of single incisions of different lengths; in this study, we intend to analyse the implications of multiple small incisions, evaluating the reaction forces, the stress on the muscles and the loss of tissue integrity sustained by the pelvic floor. The obtained results predict that an episiotomy delivery reduces the likelihood of macroscopic levator trauma by decreasing the stress on the region of insertion of the rectal area of the levator ani in the symphysis pubis . From the mechanical point of view, multiple incisions do not bring benefits compared to larger incisions. However, nothing can be ascertained about the clinical benefit of such an approach.

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