Establishing an Animal Model for the Evaluation of Vaginal Meshes

Roughly three million women in the United States give birth vaginally each year [1]. Clinically, the vagina undergoes pronounced adaptations up to the time of delivery, presumably to afford passage of the fetus [2]. Our group has suggested that if these adaptations are not sufficient or if fetus size is too large, an injury to the vagina or its supportive tissues will likely result. Vaginal injury at the time of delivery occurs quite frequently and research examining the levator ani muscle, the major muscular component of the pelvic floor, revealed injury in up to 20% of women who have given birth vaginally [3]. Therefore, vaginal birth is considered one of the greatest risk factors for pelvic floor disorders (i.e. urinary dysfunction and pelvic organ prolapse) later in life.

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Tensile Properties of the Swine Cardinal Ligament

Volume 1B: Extremity; Fluid Mechanics; Gait; Growth, Remodeling, and Repair; Heart Valves; Injury Biomechanics; Mechanotransduction and Sub-Cellular Biophysics; MultiScale Biotransport; Muscle, Tendon and Ligament; Musculoskeletal Devices; Multiscale Mechanics; Thermal Medicine; Ocular Biomechanics; Pediatric Hemodynamics; Pericellular Phenomena; Tissue Mechanics; Biotransport Design and Devices; Spine; Stent Device Hemodynamics; Vascular Solid Mechanics; Student Paper and Design Competitions ◽

10.1115/sbc2013-14294 ◽

2013 ◽

Author(s):

Frances M. Davis ◽

Ting Tan ◽

Suzanne Nicewonder ◽

Raffaella De Vita

Keyword(s):

Public Health ◽

United States ◽

Pelvic Floor Disorders ◽

The United States ◽

Pelvic Organ ◽

Health Concern ◽

Adult Women ◽

Public Health Concern ◽

Connective Tissues ◽

Pelvic Organs

Pelvic floor disorders such as urinary incontinence, fecal incontinence, and pelvic organ prolapse represent a major public health concern in the United States affecting one third of adult women [1]. These disorders are determined by structural and mechanical alterations of the pelvic organs, their supporting muscles and connective tissues that occur mainly during pregnancy, vaginal delivery, and aging [1].

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Costs of ambulatory care related to female pelvic floor disorders in the United States

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.01.015 ◽

2010 ◽

Vol 202 (5) ◽

pp. 483.e1-483.e4 ◽

Cited By ~ 37

Author(s):

Vivian W. Sung ◽

Blair Washington ◽

Christina A. Raker

Keyword(s):

United States ◽

Pelvic Floor ◽

Ambulatory Care ◽

Pelvic Floor Disorders ◽

The United States ◽

Female Pelvic Floor

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Ambulatory procedures for female pelvic floor disorders in the United States

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2010.06.055 ◽

2010 ◽

Vol 203 (5) ◽

pp. 497.e1-497.e5 ◽

Cited By ~ 40

Author(s):

Elisabeth A. Erekson ◽

Vrishali V. Lopes ◽

Christina A. Raker ◽

Vivian W. Sung

Keyword(s):

United States ◽

Pelvic Floor ◽

Pelvic Floor Disorders ◽

The United States ◽

Female Pelvic Floor ◽

Ambulatory Procedures

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Re: Costs of Ambulatory Care Related to Female Pelvic Floor Disorders in the United States

The Journal of Urology ◽

10.1016/j.juro.2010.09.070 ◽

2011 ◽

Vol 185 (1) ◽

pp. 231-232

Author(s):

David F. Penson

Keyword(s):

United States ◽

Pelvic Floor ◽

Ambulatory Care ◽

Pelvic Floor Disorders ◽

The United States ◽

Female Pelvic Floor

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Efficacy of pelvic floor muscle training and hypopressive exercises for treating pelvic organ prolapse in women: randomized controlled trial

Sao Paulo Medical Journal ◽

10.1590/s1516-31802012000100002 ◽

2012 ◽

Vol 130 (1) ◽

pp. 5-9 ◽

Cited By ~ 28

Author(s):

Bruno Teixeira Bernardes ◽

Ana Paula Magalhães Resende ◽

Liliana Stüpp ◽

Emerson Oliveira ◽

Rodrigo Aquino Castro ◽

...

Keyword(s):

Pelvic Organ Prolapse ◽

Pelvic Floor ◽

Pelvic Floor Muscle Training ◽

Pelvic Floor Muscle ◽

Controlled Trial ◽

Levator Ani ◽

Pelvic Organ ◽

Levator Ani Muscle ◽

Muscle Training ◽

Randomized Controlled

CONTEXT AND OBJECTIVE: Previous studies have shown that women with pelvic floor dysfunctions present decreased cross-sectional area (CSA) of the levator ani muscle. One way to assess the effects of training programs is to measure the CSA of the muscle, using ultrasonography. The aim here was to evaluate the efficacy of pelvic floor muscle training and hypopressive exercises for increasing the CSA of the levator ani muscle in women with pelvic organ prolapse. DESIGN AND SETTING: Prospective randomized controlled trial at the Urogynecology outpatient clinic of Universidade Federal de São Paulo. METHODS: Fifty-eight women with stage II pelvic organ prolapse were divided into three groups for physiotherapy: a pelvic floor muscle training group (GI); a hypopressive exercise group (GII); and a control group (GIII). The patients underwent transperineal ultrasonographic evaluation using a transducer of frequency 4-9 MHz. The (CSA) of the levator ani muscle was measured before physiotherapy and after 12 weeks of treatment. RESULTS: The groups were homogeneous regarding age, number of pregnancies, number of vaginal deliveries, body mass index and hormonal status. Statistically significant differences in CSA were found in GI and GII from before to after the treatment (P < 0.001), but not in relation to GIII (P = 0.816). CONCLUSIONS: The CSA of the levator ani muscle increased significantly with physiotherapy among the women with pelvic organ prolapse. Pelvic floor muscle training and hypopressive exercises produced similar improvements in the CSA of the levator ani muscle.

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