Pelvic Floor Impairments

 

The first vaginal birth is associated with a x2-fold increase in the risk of urinary incontinence and x4-risk in prolapse (conditions which are then exacerbated by aging). Current research projects in female pelvic floor impairments include:

Biomechanical Analyses of Mechanisms of Anterior Vaginal Wall Prolapse (Cystole)

Previous research in the laboratory has helped show that genital prolapse (i.e., �fallen uterus�) is associated with maternal birth-related injuries to pelvic floor structures. My research, which is funded by an NIH Specialized Center of Research (SCOR) award to the BRL, combines 3 T MR-imaging with finite element modeling to model the load-displacement behaviour of the anterior vaginal wall during valsalva (i.e.,�straining�) when intraabdominal pressures can reach 200 cm H20. In effect, the prolapse is a kind of hernia of the anterior vaginal wall. Insights should help us understand the mechanisms causing the prolapse to increase with age, a common problem, which leads to 10% of American women requiring operations. These insights should form the basis for better interventions aimed at preventing this disabling condition. My doctoral thesis will be defended in September, 2008.

Primary Investigators: Dr. John OL DeLancey (Obstetrics & Gynecology), Dr. James Ashton-Miller
Graduate Student Researcher: Luyun Chen

Biomechanical Analyses of Vaginal Birth-Related Injuries

Maternal Birth-Related injuries occur in between 10 and 15% of first time mothers. In terms of exposure time, this injury rate is higher than any sport-related injury rate in women. A recent doctoral thesis by Kuo-Cheng Lien (2007) in this laboratory, in which he developed a biomechanical model of vaginal birth, pointed out the need for measurements of pelvic floor soft tissue mechanical properties. The first part of my doctoral thesis consists of building a bi-axial test setup to measure these visco-hyperelastic properties. The second part of my thesis consists of using these data in finite element models of vaginal birth to better understand the injury mechanisms to the mother. The thesis will be completed on time by December, 2008.

Primary Investigators: Dr. James Ashton-Miller, Dr. John OL DeLancey (Obstetrics & Gynecology)
Graduate Student Researcher: Dejun Jing

Integrated System for Measuring Vaginal Birth Biomechanics

The goal of this project, which is sponsored by an NIH Specialized Center of Research (SCOR) award to the BRL, is to better understand the biomechanical factors that cause stretch-related injuries to maternal striated pelvic floor muscle during vaginal birth. As a part of this project, an integrated system for measuring fetal head and pelvic floor displacements during birth has been built and is currently being tested. Objective, quantitative, non-contact measurements from this system will be used to validate finite element models of vaginal birth.

Primary Investigators: Dr. James Ashton-Miller, Dr. John OL DeLancey (Obstetrics & Gynecology)
Graduate Student Researcher: Jinyong Kim