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Computational Modeling of Variations in Female Anatomy to Elucidate Biomechanical Mechanisms of Pelvic Organ and Tissue Functions

Routzong, Megan R. (2021) Computational Modeling of Variations in Female Anatomy to Elucidate Biomechanical Mechanisms of Pelvic Organ and Tissue Functions. Doctoral Dissertation, University of Pittsburgh. (Unpublished)

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Abstract

Pelvic floor disorders affect roughly one third of women over 50, reducing quality of life by causing pain/discomfort and/or emotional distress. These very personal and often embarrassing conditions have frequently been attributed to reduced mechanical integrity of pelvic tissues. The mechanics of female pelvic organs and tissues play a critical role in the maintenance of pelvic function, with shape and structure serving as the main drivers and indicators of biomechanical function.

For the past century, researchers have claimed that too little is known about female pelvic floor anatomy and its variation across individuals, yet its shape, soft tissue behavior, and muscle structure variability have yet to be robustly quantified. With modern computational tools and resources, we can quantify that variation and establish models that represent a broad population, rather than one individual or an exclusive cohort of women. Therefore, we aimed to quantify female anatomic variation and elucidate the relationships between that variation and female pelvic organ/tissue (dys)function.

In aim 1, statistical shape modeling (SSM) and dynamic endovaginal ultrasound established trends between urethral shape, motion, and stress urinary incontinence. Combined with a sensitivity analysis of simulated urethral passive closure, this identified the most influential tissue material properties and highlighted the importance of more robust quantification of their mechanical properties. In aim 2, SSM described bony pelvis and pelvic floor shape variation across pregnant women. From this, new, non--patient--specific geometries were generated as inputs to simulations of childbirth. This resulted in numerous finite element models that evaluated the influence of shape and pregnancy--induced remodeling on the biomechanics of vaginal birth. In aim 3, SSM and photogrammetry were utilized to define variation in female pelvic anatomy and muscle structure across an asymptomatic population of women. Differences between nulliparous (have never given birth), late pregnant, and parous (have given birth) anatomies were identified, while photogrammetry defined variation in muscle fascicle orientations. These aims demonstrate how shape can be indicative of disease progression or tissue remodeling and influence biomechanical events, while providing critical data on anatomical variation that will improve future computational models of female pelvic floor biomechanics.


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Details

Item Type: University of Pittsburgh ETD
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Routzong, Megan R.mer136@pitt.edumer1360000-0001-5551-1156
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairAbramowitch, Stevensdast9@pitt.edusdast9
Committee MemberDe Vita, Raffaelladevita@vt.edu
Committee MemberMaiti, Spandanspm54@pitt.eduspm54
Committee MemberMoalli, Pamelamoalpa@upmc.edu
Committee MemberRobertson, Annerbertson@pitt.edu
Date: 3 September 2021
Date Type: Publication
Defense Date: 15 July 2021
Approval Date: 3 September 2021
Submission Date: 13 July 2021
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 246
Institution: University of Pittsburgh
Schools and Programs: Swanson School of Engineering > Bioengineering
Degree: PhD - Doctor of Philosophy
Thesis Type: Doctoral Dissertation
Refereed: Yes
Uncontrolled Keywords: Bony pelvis, coccygeus, computational biomechanics, female pelvic anatomy, finite element modeling, pelvic floor, levator ani, morphology, photogrammetry, statistical shape modeling, stress urinary incontinence, superficial perineal muscles, vaginal childbirth
Date Deposited: 03 Sep 2021 18:42
Last Modified: 03 Sep 2021 18:42
URI: http://d-scholarship.pitt.edu/id/eprint/41420

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