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Effect of Material Properties on Predicted Vesical Pressure During a Cough in a Simplified Computational Model of the Bladder and Urethra

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Abstract

Stress urinary incontinence is a condition that affects mainly women and is characterized by the involuntary loss of urine in conjunction with an increase in abdominal pressure but in the absence of a bladder contraction. In spite of the large number of women affected by this condition, little is known regarding the mechanics associated with the maintenance of continence in women. Urodynamic measurements of the pressure acting on the bladder and the pressures developed within the bladder and the urethra offer a potential starting point for constructing computational models of the bladder and urethra during stress events. The measured pressures can be utilized in these models to provide information to specify loads and validate the models. The main goals of this study were to investigate the feasibility of incorporating human urodynamic pressure data into a computational model of the bladder and the urethra during a cough and determine if the resulting model could be validated through comparison of predicted and measured vesical pressure. The results of this study indicated that simplified models can predict vesical pressures that differ by less than 5 cmH2O (<10%) compared to urodynamic pressure measurements. In addition, varying material properties had a minimal impact on the vesical pressure and displacements predicted by the model. The latter finding limits the use of vesical pressure as a validation criterion since different parameters can yield similar results in the same model. However, the insensitivity of vesical pressure predictions to material properties ensures that the outcome of our models is not highly sensitive to tissue material properties, which are not well characterized.

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References

  1. Abrams, P., J. G. Blaivas, S. L. Stanton, and J. T. Andersen. The standardization of terminology of lower urinary tract function recommended by the International Continence Society. Int. Urogynecol. J. 1:45–58, 1990.

    Article  Google Scholar 

  2. Anderson, A. E., B. J. Ellis, and J. A. Weiss. Verification, validation and sensitivity studies in computational biomechanics. Comput. Methods Biomech. Biomed. Engin. 10:171–184, 2007.

    Article  PubMed  Google Scholar 

  3. Ashton-Miller, J. A., and J. O. L. Delancey. Functional anatomy of the female pelvic floor. Ann. N. Y. Acad. Sci. 1101:266–296, 2007.

    Article  PubMed  Google Scholar 

  4. Bastiaanssen, E. H. C., J. L. van Leeuwen, J. Vanderschoot, and P. A. Redert. A myocybernetic model of the lower urinary tract. J. Theor. Biol. 178:113–133, 1996.

    Article  PubMed  CAS  Google Scholar 

  5. Bastiaanssen, E. H. C., J. Vanderschoot, and J. L. van Leeuwen. State-space analysis of a myocybernetic model of the lower urinary tract. J. Theor. Biol. 180:215–227, 1996.

    Article  PubMed  CAS  Google Scholar 

  6. Bush, M. B., P. E. Petros, and B. R. Barrett-Lennard. On the flow through the human female urethra. J. Biomech. 30:967–969, 1997.

    Article  PubMed  CAS  Google Scholar 

  7. Chan, L., S. The, J. Titus, and V. Tse. The value of bladder wall thickness measurement in the assessment of overactive bladder syndrome. Ultrasound Obstet. Gynecol. 26:460, 2005.

    Article  Google Scholar 

  8. Chi, Y., J. Liang, and D. Yan. A material sensitivity study on the accuracy of deformable organ registration using linear biomechanical models. Med. Phys., 33:421–433, 2006.

    Google Scholar 

  9. D’Aulignac, D., J. A. C. Martins, E. B. Pires, T. Mascarenhas, and R. M. Natal Jorge. A shell finite element model of the pelvic floor muscles. Comput. Methods Biomech. Biomed. Engin. 8:339–347, 2005.

    Article  PubMed  Google Scholar 

  10. Damaser, M. S., and S. L. Lehman. The effect of urinary bladder shape on its mechanics during filling. J. Biomech. 28:725–732, 1995.

    Article  PubMed  CAS  Google Scholar 

  11. Delancey, J. O. L. Structural support of the urethra as it relates to stress urinary incontinence: the hammock hypothesis. Am. J. Obstet. Gynecol. 170:1713–1720, 1994.

    PubMed  CAS  Google Scholar 

  12. Drake, R. L., W. Vogl, and A. W. M. Mitchell. Gray’s Anatomy for Students. New York: Elsevier Churchill Livingstone, 2005.

    Google Scholar 

  13. Enhorning, G., E. R. Miller, and F. Hinman. Simultaneous recording of intravesical and intraurethral pressure. Acta Chir. Scand. 276:1–68, 1961.

    Google Scholar 

  14. Fung, Y. C. Biomechanics Mechanical Properties of Living Tissues. New York: Springer, 1993.

    Google Scholar 

  15. Haderer, J. M., H. K. Pannu, R. Genadry, and G. M. Hutchins. Controversies in female urethral anatomy and their significance for understanding urinary continence: observations and literature review. Int. Urogynecol. J. 13:236–252, 2002.

    Article  CAS  Google Scholar 

  16. Hallquist, J. O. LS Dyna Keyword Manual. Livermore: Livermore Software Technology Co., 2008.

    Google Scholar 

  17. Hallquist, J. O. LS Dyna Theory Manual. Livermore: Livermore Software Technology Co., 2008.

    Google Scholar 

  18. Haridas, B., H. Hong, R. Minoguchi, S. Owens, and T. Osborn. PelvicSim—a computational experimental system for biomechanical evaluation of female pelvic floor organ disorders and associated minimally invasive interventions. Stud. Health Technol. Inform. 119:182–187, 2006.

    PubMed  Google Scholar 

  19. Hosein, R. A., and D. J. Griffiths. Computer simulation of the neural control of the bladder and urethra. Neurourol. Urodyn. 9:601–618, 1990.

    Article  Google Scholar 

  20. Institute of Medicine. Women’s Health Research: Progress, Pitfalls and Promise. Washington, DC: The National Academies Press, 2010.

    Google Scholar 

  21. Janda, S., F. C. T. van der Helm, and S. B. de Blok. Measuring morphological parameters of the pelvic floor for finite element modeling purposes. J. Biomech. 36:749–757, 2003.

    Article  PubMed  Google Scholar 

  22. Kim, K. J. Biomechanical analyses of female stress urinary incontinence. Doctor of Philosophy (mechanical engineering) dissertation, University of Michigan, 1994.

  23. Lose, G., D. Griffiths, G. Hosker, S. Kulseng-Hanssen, D. Perucchini, W. Schafer, P. Thind, and E. Versi. Standardization of urethral pressure measurement: report from the standardisation sub-committee of the International Continence Society. Neurourol. Urodyn. 21:258–260, 2002.

    Article  PubMed  Google Scholar 

  24. Netter, F. H. Atlas of Human Anatomy. Philadelphia: Saunders Elsevier, 2006.

    Google Scholar 

  25. Norton, P., and L. Brubaker. Urinary incontinence in women. Lancet 367:57–67, 2006.

    Article  PubMed  Google Scholar 

  26. Petros, P. E., and U. I. Ulmsten. An integral theory of female urinary incontinence. Acta Obstet. Gynecol. Scand. 69:7–31, 1990.

    Article  Google Scholar 

  27. Spangberg, A., H. Terio, A. Engberg, and P. Ask. Quantification of urethral function based on Griffiths model of flow through elastic tubes. Neurourol. Urodyn. 8:29–52, 1989.

    Article  Google Scholar 

  28. Taber, L. Nonlinear Theory of Elasticity: Applications in Biomechanics. River Edge, NJ: World Scientific Publishing Co., 2004.

    Book  Google Scholar 

  29. Umek, W. H., T. Laml, D. Stutterecker, A. Obermair, S. Leodolter, and E. Hanzal. The urethra during pelvic floor contraction observations on three-dimensional ultrasound. Ultrasound Obstet. Gynecol. 100:796–800, 2002.

    Google Scholar 

  30. Umek, W. H., A. Obermair, D. Stutterecker, G. Hausler, S. Leodolter, and E. Hanzal. Three-dimensional ultrasound of the female urethra: comparing transvaginal and transrectal scanning. Obstet. Gynecol. 17:425–430, 2001.

    CAS  Google Scholar 

  31. Yamada, H. Strength of Biological Materials. Baltimore, MD: Williams and Wilkins, 1970.

    Google Scholar 

  32. Zhang, Y., S. Kim, A. G. Erdman, K. P. Roberts, and G. W. Timm. Feasibility of using a computer modeling approach to study SUI induced by landing a jump. Ann. Biomed. Eng. 37:1425–1433, 2009.

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was funded in part through the following grants: K24 DK064044-03 and K23 HD047325-010. Additional support was provided by the Ohio Supercomputer Center (Columbus, OH), the Cleveland Clinic, and the Rehabilitation Research and Development Service of the Department of Veterans Affairs.

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Authors and Affiliations

  1. Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland Clinic Main Campus, Mail Code ND20, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Thomas Spirka & Margot S. Damaser

  2. Department of Chemical and Biomedical Engineering, Cleveland State University, Cleveland, OH, USA

    Thomas Spirka & Margot S. Damaser

  3. Department of Obstetrics and Gynecology, Loyola University Chicago Stritch School of Medicine, Maywood, IL, USA

    Kimberly Kenton & Linda Brubaker

  4. Department of Veterans Affairs, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA

    Margot S. Damaser

Authors
  1. Thomas Spirka
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  2. Kimberly Kenton
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  3. Linda Brubaker
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  4. Margot S. Damaser
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Correspondence to Margot S. Damaser.

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Associate Editor Joel D. Stitzel oversaw the review of this article.

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Spirka, T., Kenton, K., Brubaker, L. et al. Effect of Material Properties on Predicted Vesical Pressure During a Cough in a Simplified Computational Model of the Bladder and Urethra. Ann Biomed Eng 41, 185–194 (2013). https://doi.org/10.1007/s10439-012-0637-x

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  • DOI: https://doi.org/10.1007/s10439-012-0637-x

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