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Quantification of the Biaxial Mechanics of the Female Pelvic Floor

acase@tulane.edu / Women’s reproductive health is a severely understudied field and is associated
with an abundance of clinically significant pathologies such as pelvic organ prolapse
(POP) and preterm birth (PTB). While the exact etiologies of these disorders are
unknown, onset is understood to be predominately due to failure of the muscles and
connective tissues of the pelvic floor. These failures are attributed to the suboptimal
remodeling and maladaptive constituent turnover of the soft tissue extracellular matrix
(ECM) including elastic fibers, collagen fibers, glycosaminoglycans / proteoglycans
(GAGs/PGs), and smooth muscle cells. Both the vagina and the uterosacral ligament
(USL) act as supportive structures that maintain the healthy state of the pelvic floor.
Disruption of the elastic fiber and GAG metabolism within the extracellular matrix of
these tissues has been suggested to result in the mechanical failure associated with pelvic
floor disorders, however, the relationship between microstructure and mechanics is
relatively unknown. Histological analysis paired with the biaxial testing of these pelvic
floor supporting structures is an important step in providing additional insight into the
specific structure-function mechanisms of these tissues. Therefore, the overall objective
of this study is to establish a basic understanding of the structure and function of the
extracellular matrix constituents within vital soft tissue (vagina, USL) of the murine and
human pelvic floor. To elucidate the role of specific constituents, vaginal tissue from
female mice in estrus were tested using an extension-inflation biaxial testing protocol pre
and post digestion of both elastin and hyaluronan, the most abundant GAG in the
extracellular matrix. The digestion of elastin (supported by histological area fraction
analysis) resulted in a decreased compliance and an increased dilation of the vaginal wall.
Results from the digestion of hyaluronan were inconclusive, as the mechanical response
varied with treatment time. Finally, human uterosacral ligaments of postmenopausal,
prolapsed patients were tested on a custom built planar biaxial device. This study
revealed an inverse relationship between the mechanical stiffness parameters and the
ratio of elastin to collagen within the USL. The present findings provide useful
information to help understand the etiology behind POP, and help in the development of
computational models for the prediction and assessment of observed microstructural
changes associated with soft tissue failure. / 1 / Daniel Capone

  1. tulane:79063
Identiferoai:union.ndltd.org:TULANE/oai:http://digitallibrary.tulane.edu/:tulane_79063
Date January 2018
ContributorsCapone, Daniel (author), Miller, Kristin (Thesis advisor), School of Science & Engineering Biomedical Engineering (Degree granting institution)
PublisherTulane University
Source SetsTulane University
LanguageEnglish
Detected LanguageEnglish
TypeText
Formatelectronic, 123
RightsNo embargo, Copyright is in accordance with U.S. Copyright law.

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