Martin, Liam Christopher
(2024)
Quantitative Analysis and Finite Element Modeling of Pelvic Organ Motion in Asymptomatic and Symptomatic Women.
Doctoral Dissertation, University of Pittsburgh.
(Unpublished)
Abstract
Between one in three women will be diagnosed with at least one form of pelvic floor dysfunction during their lifetime. The most common clinically diagnosed conditions are pelvic organ prolapse (POP), which involves the protrusion of one or more pelvic organs towards or past the vaginal hymen, and stress urinary incontinence, the involuntary loss of urine during normal daily activities. Both conditions are believed to be caused by laxity of the supportive structures of the affected organ.
Recent research has started to use dynamic imaging modalities and computational methods to elucidate which structures are primarily responsible. However, much of this research lacks quantitative data from asymptomatic women for comparison. Therefore, the purpose of this work was to use 2- and 3-dimensional morphometric measurements and computational methods to quantify the asymptomatic behaviors of the pelvic organs and compare those measurements and analyses to symptomatic behaviors to better understand the development and progression of pelvic floor dysfunction. We will follow up these comparisons by outlining the process of creating, testing, and validating a finite element model of defecation in an asymptomatic woman, which we will compare to existing MR defecography image series.
In this work, we found significant overlap between POP classification measures based on the radiologic grading scale of POP in nulligravid asymptomatic women. This overlap indicates potential areas of error, which may contribute to the uncorrelated relationship between MR defecography and physical examinations. These studies also supported previous work conducted in our laboratory that lacked truly asymptomatic data for comparison (Aim 1). While designing the finite element model of MR defecography, we discovered that existing finite element solvers struggled to handle the complex contact that can occur in the pelvic region. Consequently, we collaborated with the creators of a novel finite element solver that addressed many of the pitfalls we were experiencing to verify their solver for biomechanics problems (Aim 2). Finally, Aim 3 outlined the process for designing and validating a finite element model of defecation. These combined studies offer valuable insight into the behaviors of the pelvic organs and their relation to the development of pelvic floor dysfunction.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
|
| ETD Committee: |
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| Date: |
6 September 2024 |
| Date Type: |
Publication |
| Defense Date: |
18 July 2024 |
| Approval Date: |
6 September 2024 |
| Submission Date: |
16 July 2024 |
| Access Restriction: |
1 year -- Restrict access to University of Pittsburgh for a period of 1 year. |
| Number of Pages: |
245 |
| 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: |
Pelvic Floor Dysfunction, Finite Element Simulation, Imaging Analyses |
| Date Deposited: |
06 Sep 2024 20:03 |
| Last Modified: |
06 Sep 2024 20:03 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/46691 |
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