ArticleJournal of biomechanics2015
A multi-compartment 3-D finite element model of rectocele and its interaction with cystocele.
Article in Journal of biomechanics, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers.
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Who cites it
30 citing papers in PubMed.
- Balanced Sacrospinous Ligament Fixation in Uterine Prolapse: A Preliminary Retrospective Comparative Study.International urogynecology journal · 2026Article
- Compartment-Specific Associations Between Perineal Body Length and Pelvic Organ Prolapse in Postpartum Women.International urogynecology journal · 2026Article
- Semi-supervised deep learning for uterus and bladder segmentation on female pelvic floor magnetic resonance imaging with limited labeled data.American journal of obstetrics and gynecology · 2026Article
- A new understanding of the mechanical mechanism of posterior vaginal prolapse based on magnetic resonance imaging.Nagoya journal of medical science · 2025Article
- Dynamic biomechanical equilibrium in pelvic organ prolapse: from mechanistic insights to precision reconstruction.Frontiers in medicine · 2025Article
- Finite element modeling in obstetrics and gynecology: advances, applications, and challenges.Frontiers in medicine · 2025Review
- Post-operative outcomes associated with anterior mesh location after laparoscopic sacrocolpopexy.Archives of gynecology and obstetrics · 2024Article
- A systematic comparison between FEBio and PolyFEM for biomechanical systems.Computer methods and programs in biomedicine · 2024Article
- Finite element analysis of female pelvic organ prolapse mechanism: current landscape and future opportunities.Frontiers in medicine · 2024Review
- Variations in structural support site failure patterns by prolapse size on stress 3D MRI.International urogynecology journal · 2023Article
- A novel anchoring system for pelvic organ prolapse repair: an observational study.International urogynecology journal · 2023Observational
- The influence of the combined impairments and apical mesh surgery on the biomechanical behavior of the pelvic floor system.Frontiers in bioengineering and biotechnology · 2023Article
- Comparison of in vivo visco-hyperelastic properties of uterine suspensory tissue in women with and without pelvic organ prolapse.Journal of the mechanical behavior of biomedical materials · 2023Article
- Multi-label classification of pelvic organ prolapse using stress magnetic resonance imaging with deep learning.International urogynecology journal · 2022Article
- Three-dimensional self super-resolution for pelvic floor MRI using a convolutional neural network with multi-orientation data training.Medical physics · 2022Article
- The distribution of pelvic organ support defects in women undergoing pelvic organ prolapse surgery and compartment specific risk factors.International urogynecology journal · 2022Observational
- Relationship between high intra-abdominal pressure and compliance of the pelvic floor support system in women without pelvic organ prolapse: A finite element analysis.Frontiers in medicine · 2022Article
- Changes in cardinal ligament length and curvature with parity and prolapse and their relation to level III hiatus measures.International urogynecology journal · 2022Article
- Rectal-vaginal pressure gradient in patients with pelvic organ prolapse and symptomatic rectocele.BMC women's health · 2021Article
- Specific Changes in Manometric Parameters are Associated with Non-improvement in Symptoms after Rectocele Repair.International urogynecology journal · 2020Observational
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
Abstract
We developed a subject-specific 3-D finite element model to understand the mechanics underlying formation of female pelvic organ prolapse, specifically a rectocele and its interaction with a cystocele. The model was created from MRI 3-D geometry of a healthy 45 year-old multiparous woman. It included anterior and posterior vaginal walls, levator ani muscle, cardinal and uterosacral ligaments, anterior and posterior arcus tendineus fascia pelvis, arcus tendineus levator ani, perineal body, perineal membrane and anal sphincter. Material properties were mostly from the literature. Tissue impairment was modeled as decreased tissue stiffness based on previous clinical studies. Model equations were solved using Abaqus v 6.11. The sensitivity of anterior and posterior vaginal wall geometry was calculated for different combinations tissue impairments under increasing intraabdominal pressure. Prolapse size was reported as pelvic organ prolapse quantification system (POP-Q) point at point Bp for rectocele and point Ba for cystocele. Results show that a rectocele resulted from impairments of the levator ani and posterior compartment support. For 20% levator and 85% posterior support impairments, simulated rectocele size (at POP-Q point: Bp) increased 0.29 mm/cm H2O without apical impairment and 0.36 mm/cm H2O with 60% apical impairment, as intraabdominal pressures increased from 0 to 150 cm H2O. Apical support impairment could result in the development of either a cystocele or rectocele. Simulated repair of posterior compartment support decreased rectocele but increased a preexisting cystocele. We conclude that development of rectocele and cystocele depend on the presence of anterior, posterior, levator and/or or apical support impairments, as well as the interaction of the prolapse with the opposing compartment.
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