Background: Quantitative biomechanical characterization of pelvic supportive
structures and functions in vivo is
thought to provide insight into pathophysiology of pelvic organ prolapse (POP).
An innovative approach—vaginal tactile imaging—allows biomechanical mapping of
the female pelvic floor to quantify tissue elasticity, pelvic support, and
pelvic muscle functions. The Vaginal Tactile Imager (VTI) records high
definition pressure patterns from vaginal walls under an applied tissue
deformation and during pelvic floor muscle contractions. Objective: To
explore an extended set of 52 biomechanical parameters for differentiation and
characterization of POP relative to normal pelvic floor conditions. Methods: 96 subjects with normal and POP conditions were included in the data analysis
from multi-site observational, case-controlled studies; 42 subjects had normal
pelvic floor conditions and 54 subjects had POP. The VTI, model 2S, was used
with an analytical software package to calculate automatically 52 biomechanical
parameters for 8 VTI test procedures (probe insertion, elevation, rotation,
Valsalva maneuver, voluntary muscle contractions in 2 planes, relaxation, and
reflex contraction). The groups were equalized for subject age and parity. Results: The ranges, mean values, and standard deviations for all 52 VTI parameters were
established. 33 of 52 parameters were identified as statistically sensitive (p<0.05; t-test) to the POP
development. Among these 33 parameters, 11 parameters show changes (decrease)
in tissue elasticity, 8 parameters
References
[1]
Siddiqui, N.Y., Gregory, W.T., Handa, V.L., DeLancey, J.O.L., Richter, H.E., Moalli, P., Barber, M.D., Pulliam, S., Visco, A.G., Alperin, M., Medina, C., Fraser, M.O. and Bradley, C.S. (2018) American Urogynecologic Society Prolapse Consensus Conference Summary Report. Female Pelvic Medicine & Reconstructive Surgery, 24, 257.
[2]
Jeffery, S. and Roovers, J.P. (2018) Quo Vadis, Vaginal Mesh in Pelvic Organ Prolapse? International Urogynecology Journal, 29, 1073-1074.
https://doi.org/10.1007/s00192-018-3659-6
[3]
Egorov, V., van Raalte, H. and Sarvazyan, A. (2010) Vaginal Tactile Imaging. IEEE Transactions on Biomedical Engineering, 57, 1736-1744.
https://doi.org/10.1109/TBME.2010.2045757
[4]
Egorov, V., van Raalte, H. and Lucente, V. (2012) Quantifying Vaginal Tissue Elasticity under Normal and Prolapse Conditions by Tactile Imaging. International Urogynecology Journal, 23, 459-466. https://doi.org/10.1007/s00192-011-1592-z
[5]
Egorov, V., van Raalte, H., Lucente, V. and Sarvazyan, A. (2016) Biomechanical Characterization of the Pelvic Floor Using Tactile Imaging. In: Hoyte, L. and Damaser, M.S., Eds., Biomechanics of the Female Pelvic Floor, Elsevier, London, 317-348. https://doi.org/10.1016/B978-0-12-803228-2.00016-7
[6]
Kim, K., Egorov, V. and Shobeiri, S.A. (2017) Emerging Imaging Technologies and Techniques. In: Shobeiri, A., Ed., Practical Pelvic Floor Ultrasonography, 2nd Edition, Springer International Publishing AG, 327-336.
https://doi.org/10.1007/978-3-319-52929-5_17
[7]
van Raalte, H., Lucente, V., Ephrain, S., Murphy, M., Bhatia, N., Sarvazyan, N. and Egorov, V. (2016) Intra- and Inter-Observer Reproducibility of Vaginal Tactile Imaging. Female Pelvic Medicine & Reconstructive Surgery, 22, S130-131.
[8]
Lucente, V., van Raalte, H., Murphy, M. and Egorov, V. (2017) Biomechanical Paradigm and Interpretation of Female Pelvic Floor Conditions before a Treatment. International Journal of Women’s Health, 9, 521-550.
https://doi.org/10.2147/IJWH.S136989
[9]
Egorov, V., Murphy, M., Lucente, V., van Raalte, H., Ephrain, S., Bhatia, N. and Sarvazyan, N. (2018) Quantitative Assessment and Interpretation of Vaginal Conditions. Sexual Medicine, 6, 39-48. https://doi.org/10.1016/j.esxm.2017.08.002
[10]
van Raalte, H. and Egorov, V. (2015) Tactile Imaging Markers to Characterize Female Pelvic Floor Conditions. Open Journal of Obstetrics and Gynecology, 5, 505-515. https://doi.org/10.4236/ojog.2015.59073
[11]
Egorov, V., Ayrapetyan, S. and Sarvazyan, A.P. (2006) Prostate Mechanical Imaging: 3-D Image Composition and Feature Calculations. IEEE Transactions on Medical Imaging, 25, 1329-1340. https://doi.org/10.1109/TMI.2006.880667
[12]
Egorov, V. and Sarvazyan, A.P. (2008) Mechanical Imaging of the Breast. IEEE Transactions on Medical Imaging, 27, 1275-1287.
https://doi.org/10.1109/TMI.2008.922192
[13]
Shobeiri, S.A. (2017) Practical Pelvic Floor Ultrasonography. A Multicompartmental Approach to 2D/3D/4D Ultrasonography of the Pelvic Floor. 2nd Edition, Springer International Publishing AG, 1-368.
https://doi.org/10.1007/978-3-319-52929-5
[14]
DeLancey, J.O. (2016) Pelvic Floor Anatomy and Pathology. In: Hoyte, L. and Damaser, M.S., Eds., Biomechanics of the Female Pelvic Floor, Elsevier, London, 13-51. https://doi.org/10.1016/B978-0-12-803228-2.00002-7
[15]
Dietz, H.P. (2016) Pelvic Floor Ultrasound. Atlas and Text Book. Creative Commons Attribution License. Springwood, Australia, 1-127.
[16]
Hoyte, L., Ye, W., Brubaker, L., Fielding, J.R., Lockhart, M.E., Heilbrun, M.E., Brown, M.B. and Warfield, S.K. (2011) Segmentations of MRI Images of the Female Pelvic Floor: A Study of Inter- and Intra-Reader Reliability. Journal of Magnetic Resonance Imaging, 33, 684-691. https://doi.org/10.1002/jmri.22478
[17]
Petros, P. (2010) The Female Pelvic Floor: Function, Dysfunction and Management According to the Integral Theory. 3rd Edition, Springer, Berlin, 1-330.
https://doi.org/10.1007/978-3-642-03787-0
[18]
Bump, R.C., Mattiasson, A., Bo, K., et al. (1996) The Standardization of Terminology of Female Pelvic Organ Prolapse and Pelvic Floor Dysfunction. American Journal of Obstetrics and Gynecology, 175, 10-17.
https://doi.org/10.1016/S0002-9378(96)70243-0
[19]
McGill, R., Tukey, J.W. and Larsen, W.A. (1978) Variations of Box Plots. American Statistician, 32, 12-16.
