Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2011, Vol. 07 ›› Issue (05): 426 -429. doi: 10.3877/cma.j.issn.1673-5250.2011.05.005

Original Article

Three-Dimensional Finite Element Analysis of the Feminine Pelvic Floor in Pathological State

Hong-fang SONG, Xue-ying WANG, Yue HUANG, Cheng-xiang NI, Ling-ling LEI, Le MA   

  1. Institute of Biomedical Engineering, Capital Medical University, Beijing 100069, China
  • Published:2011-10-01
  • Supported by:
    * Project No. 3082010 and 10802053, supported by the Natural Science Foundation of Beijing and National Natural Science Foundation of China
Objective

To build the mechanical model of the m. levator ani to analyze its stress distribution in pathological state, and provide reference to further know pelvic floor dysfunction(PFD) in terms of mechanics.

Methods

Based on magnetic resonance imaging (MRI) of the pelvic floor, to reconstruct the geometric structure of the m. levator ani using the medical imaging software MIMICS and to simulate the stress distribution of the m. levator ani using the finite element method.

Results

For both the viscera organs prolapse and the stress urinary incontinence the maximum stress position were same but the magnitude was difference in the m. levator ani. The maximum stress in the m. levator ani was more higher between the viscera organs prolapse and the type I stress urinary incontinence, but it was lowest for the type Ⅲ stress urinary incontinence among type Ⅰ to Ⅲ stress urinary incontinence and the viscera organs prolapse.

Conclusion

High intra-abdominal pressure will all produce high stress in the m. levator ani for the four pathological states, thus it is easy to damage the m. levator ani. The result will provide some theory reference for preventing PFD in clinic.

图1 肛提肌的三维模型(A:无网格;B:有网格)
图2 盆底结构重建三维模型
图3 盆腔脏器脱垂时应力云图
图4 压力性尿失禁Ⅰ型应力云图
图5 压力性尿失禁Ⅱ型应力云图
图6 压力性尿失禁Ⅲ型应力云图
1 Schumacher S. Epidemiology and etiology of urinary incontinence in the elderly [J]. Urologe A, 2007, 46(4):357-358, 360-362.
2 Liu JK, Xin J. Human body three-dimensional surface reconstruction and achieve of medical images [J]. Comput Engin Applicat, 2002, 38(14): 97-98.[刘家康,辛静.人体医学图像三维表面重构的实现[J].计算机工程与应用,2002,38(14):97-98.]
3 d'Aulignac D, Martins JA, Pires EB, et al. A shell finite element model of the pelvic floor muscles [J]. Comput Method Biomech Biomed Engin, 2005, 8(5): 339-347.
4 Zhao YF, Zhang XW, Chen RX. Analysis of urodynamics in women with pelvic organ prolapse [J/CD]. Chin J Obstet Gynecol Pediatr (Elctronic Ed), 2009, 5(3): 9-11.[赵雅绯,张晓薇,陈日笑.女性盆腔脏器脱垂的尿动力学分析[J/CD].中华妇幼临床医学杂志:电子版,2009,5(3):9-11.]
5 Wang SC, McGuire EJ, Bloom DA. A bladder pressure management system for myclodysplasia-clinical outcome [J]. J Urol, 1988, 140: 1499-1502.
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