Image-based simulation of urethral distensibility and flow resistance as a function of pelvic floor anatomy

Franklin Yao, Melissa A. Laudano, Stephan Seklehner, Bilal Chughtai, Richard K. Lee

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Aims The goal of this study is to develop an image-based model of urethral distention and resistance in women with and without SUI. Methods A biomechanical vector force model was created to simulate the mechanical deformation of pelvic floor structures during cough and Valsalva in order to measure urethral distension and predict flow resistance patterns. Dynamic MRI images were used to create a spatial model to construct an accurate representation of tissue thickness and location, which was combined with tissue property values (MATLAB 2011a, MathWorks, Natick, MA). Spatial profiles were created to demonstrate the effects of hypermobility and tissue property variability on distensibility and flow resistance along the urethra. Sensitivity analyses were conducted to demonstrate the relationship between flow resistance and various tissue properties. Results The average distension for incontinent cases (3.8-mm) was significantly greater than that of continent cases (2.6-mm) (t-=-3.3083, df-=-8, P-<-0.01), corresponding to a 70% drop in average resistance to urine flow. Sensitivity analyses demonstrated that the stiffness and contractility of the vagina and urethra had the greatest effect on continence. Conclusions We present a novel, 2-dimensional biomechanical model of female stress urinary incontinence (SUI) that relates the effects of various factors such as tissue elasticity, pelvic floor structure, and muscle activation. A better understanding of the pathophysiology underlying SUI has potential implications for the creation of novel targeted treatments.

Original languageEnglish (US)
Pages (from-to)664-668
Number of pages5
JournalNeurourology and Urodynamics
Volume34
Issue number7
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

Fingerprint

Pelvic Floor
Anatomy
Stress Urinary Incontinence
Urethra
Elasticity
Vagina
Cough
Urine
Muscles

Keywords

  • models
  • stress
  • theoretical
  • urethra
  • urinary incontinence

ASJC Scopus subject areas

  • Clinical Neurology
  • Urology
  • Medicine(all)

Cite this

Image-based simulation of urethral distensibility and flow resistance as a function of pelvic floor anatomy. / Yao, Franklin; Laudano, Melissa A.; Seklehner, Stephan; Chughtai, Bilal; Lee, Richard K.

In: Neurourology and Urodynamics, Vol. 34, No. 7, 01.01.2015, p. 664-668.

Research output: Contribution to journalArticle

Yao, Franklin ; Laudano, Melissa A. ; Seklehner, Stephan ; Chughtai, Bilal ; Lee, Richard K. / Image-based simulation of urethral distensibility and flow resistance as a function of pelvic floor anatomy. In: Neurourology and Urodynamics. 2015 ; Vol. 34, No. 7. pp. 664-668.
@article{091f32f899a84e43a8c5ceacfc460441,
title = "Image-based simulation of urethral distensibility and flow resistance as a function of pelvic floor anatomy",
abstract = "Aims The goal of this study is to develop an image-based model of urethral distention and resistance in women with and without SUI. Methods A biomechanical vector force model was created to simulate the mechanical deformation of pelvic floor structures during cough and Valsalva in order to measure urethral distension and predict flow resistance patterns. Dynamic MRI images were used to create a spatial model to construct an accurate representation of tissue thickness and location, which was combined with tissue property values (MATLAB 2011a, MathWorks, Natick, MA). Spatial profiles were created to demonstrate the effects of hypermobility and tissue property variability on distensibility and flow resistance along the urethra. Sensitivity analyses were conducted to demonstrate the relationship between flow resistance and various tissue properties. Results The average distension for incontinent cases (3.8-mm) was significantly greater than that of continent cases (2.6-mm) (t-=-3.3083, df-=-8, P-<-0.01), corresponding to a 70{\%} drop in average resistance to urine flow. Sensitivity analyses demonstrated that the stiffness and contractility of the vagina and urethra had the greatest effect on continence. Conclusions We present a novel, 2-dimensional biomechanical model of female stress urinary incontinence (SUI) that relates the effects of various factors such as tissue elasticity, pelvic floor structure, and muscle activation. A better understanding of the pathophysiology underlying SUI has potential implications for the creation of novel targeted treatments.",
keywords = "models, stress, theoretical, urethra, urinary incontinence",
author = "Franklin Yao and Laudano, {Melissa A.} and Stephan Seklehner and Bilal Chughtai and Lee, {Richard K.}",
year = "2015",
month = "1",
day = "1",
doi = "10.1002/nau.22624",
language = "English (US)",
volume = "34",
pages = "664--668",
journal = "Neurourology and Urodynamics",
issn = "0733-2467",
publisher = "Wiley-Liss Inc.",
number = "7",

}

TY - JOUR

T1 - Image-based simulation of urethral distensibility and flow resistance as a function of pelvic floor anatomy

AU - Yao, Franklin

AU - Laudano, Melissa A.

AU - Seklehner, Stephan

AU - Chughtai, Bilal

AU - Lee, Richard K.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Aims The goal of this study is to develop an image-based model of urethral distention and resistance in women with and without SUI. Methods A biomechanical vector force model was created to simulate the mechanical deformation of pelvic floor structures during cough and Valsalva in order to measure urethral distension and predict flow resistance patterns. Dynamic MRI images were used to create a spatial model to construct an accurate representation of tissue thickness and location, which was combined with tissue property values (MATLAB 2011a, MathWorks, Natick, MA). Spatial profiles were created to demonstrate the effects of hypermobility and tissue property variability on distensibility and flow resistance along the urethra. Sensitivity analyses were conducted to demonstrate the relationship between flow resistance and various tissue properties. Results The average distension for incontinent cases (3.8-mm) was significantly greater than that of continent cases (2.6-mm) (t-=-3.3083, df-=-8, P-<-0.01), corresponding to a 70% drop in average resistance to urine flow. Sensitivity analyses demonstrated that the stiffness and contractility of the vagina and urethra had the greatest effect on continence. Conclusions We present a novel, 2-dimensional biomechanical model of female stress urinary incontinence (SUI) that relates the effects of various factors such as tissue elasticity, pelvic floor structure, and muscle activation. A better understanding of the pathophysiology underlying SUI has potential implications for the creation of novel targeted treatments.

AB - Aims The goal of this study is to develop an image-based model of urethral distention and resistance in women with and without SUI. Methods A biomechanical vector force model was created to simulate the mechanical deformation of pelvic floor structures during cough and Valsalva in order to measure urethral distension and predict flow resistance patterns. Dynamic MRI images were used to create a spatial model to construct an accurate representation of tissue thickness and location, which was combined with tissue property values (MATLAB 2011a, MathWorks, Natick, MA). Spatial profiles were created to demonstrate the effects of hypermobility and tissue property variability on distensibility and flow resistance along the urethra. Sensitivity analyses were conducted to demonstrate the relationship between flow resistance and various tissue properties. Results The average distension for incontinent cases (3.8-mm) was significantly greater than that of continent cases (2.6-mm) (t-=-3.3083, df-=-8, P-<-0.01), corresponding to a 70% drop in average resistance to urine flow. Sensitivity analyses demonstrated that the stiffness and contractility of the vagina and urethra had the greatest effect on continence. Conclusions We present a novel, 2-dimensional biomechanical model of female stress urinary incontinence (SUI) that relates the effects of various factors such as tissue elasticity, pelvic floor structure, and muscle activation. A better understanding of the pathophysiology underlying SUI has potential implications for the creation of novel targeted treatments.

KW - models

KW - stress

KW - theoretical

KW - urethra

KW - urinary incontinence

UR - http://www.scopus.com/inward/record.url?scp=84939153415&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84939153415&partnerID=8YFLogxK

U2 - 10.1002/nau.22624

DO - 10.1002/nau.22624

M3 - Article

VL - 34

SP - 664

EP - 668

JO - Neurourology and Urodynamics

JF - Neurourology and Urodynamics

SN - 0733-2467

IS - 7

ER -