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Computational and Mathematical Methods in Medicine
Volume 2018 (2018), Article ID 9518076, 16 pages
https://doi.org/10.1155/2018/9518076
Research Article

Modelling of Soft Connective Tissues to Investigate Female Pelvic Floor Dysfunctions

Biomechanics Laboratory, Institute of Bioengineering, Aachen University of Applied Sciences, 52428 Jülich, Germany

Correspondence should be addressed to Manfred Staat

Received 31 August 2017; Revised 4 December 2017; Accepted 11 December 2017; Published 15 January 2018

Academic Editor: Maria N. D. S. Cordeiro

Copyright © 2018 Aroj Bhattarai and Manfred Staat. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

After menopause, decreased levels of estrogen and progesterone remodel the collagen of the soft tissues thereby reducing their stiffness. Stress urinary incontinence is associated with involuntary urine leakage due to pathological movement of the pelvic organs resulting from lax suspension system, fasciae, and ligaments. This study compares the changes in the orientation and position of the female pelvic organs due to weakened fasciae, ligaments, and their combined laxity. A mixture theory weighted by respective volume fraction of elastin-collagen fibre compound (5%), adipose tissue (85%), and smooth muscle (5%) is adopted to characterize the mechanical behaviour of the fascia. The load carrying response (other than the functional response to the pelvic organs) of each fascia component, pelvic organs, muscles, and ligaments are assumed to be isotropic, hyperelastic, and incompressible. Finite element simulations are conducted during Valsalva manoeuvre with weakened tissues modelled by reduced tissue stiffness. A significant dislocation of the urethrovesical junction is observed due to weakness of the fascia (13.89 mm) compared to the ligaments (5.47 mm). The dynamics of the pelvic floor observed in this study during Valsalva manoeuvre is associated with urethral-bladder hypermobility, greater levator plate angulation, and positive Q-tip test which are observed in incontinent females.