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Multicenter Study
. 2021 Jan 1;27(1):e28-e38.
doi: 10.1097/SPV.0000000000000786.

Predictive Value of Biomechanical Mapping for Pelvic Organ Prolapse Surgery

Vladimir Egorov  1 , Peter Takacs  2 , S Abbas Shobeiri  3 , Lennox Hoyte  4 , Vincent Lucente  5 , Heather van Raalte  6 , Noune Sarvazyan  1
Affiliations
Multicenter Study

Predictive Value of Biomechanical Mapping for Pelvic Organ Prolapse Surgery

Vladimir Egorov et al. Female Pelvic Med Reconstr Surg. .

Abstract

Objective: This study examined biomechanical changes in pelvic floor after urogynecological surgery.

Methods: This multisite clinical study was designed to explore changes in tissue elasticity, pelvic support, and certain functions (contractive strength, muscle relaxation speed, muscle motility) after pelvic organ prolapse (POP) surgery. A biomechanical mapping of the pelvic floor was performed before and 4 to 6 months after the surgery. The biomechanical data for 52 parameters were acquired by vaginal tactile imaging for manually applied deflection pressures to vaginal walls and pelvic muscle contractions. The two-sample t-test (P < 0.05) was used to test the null hypothesis that presurgery data in group 1 (positive parameter change after surgery) and presurgery data in group 2 (negative parameter change after surgery) belonged to the same distribution.

Results: A total of 78 subjects with 255 surgical procedures were analyzed across 5 participating clinical sites. All 52 t-tests for group 1 versus group 2 had P value in the range from 4.0 × 10-10 to 4.3 × 10-2 associating all of the 52 parameter changes after surgery with the presurgical conditions. The P value of before and after surgery correlation ranged from 3.7 × 10-18 to 1.6 × 10-2 for 50 of 52 tests, with Pearson correlation coefficient ranging from -0.79 to -0.27. Thus, vaginal tactile imaging parameters strongly correlated weak pelvic floor presurgery with the positive POP surgery outcome of improved biomechanical properties.

Conclusions: Pelvic organ prolapse surgery, in general, improves the biomechanical conditions and integrity of the weak pelvic floor. The proposed biomechanical parameters can predict changes resulting from POP surgery.

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Conflict of interest statement

Vladimir Egorov is a co-founder and a CEO of Advanced Tactile Imaging; Peter Takacs, S. Abbas Shobeiri, Lennox Hoyte, and Vincent Lucente have no conflicts of interest; Heather van Raalte is a minor shareholder in Advanced Tactile Imaging; and Noune Sarvazyan is a major shareholder in Artann Laboratories.

Figures

Figure 1.
Figure 1.
Anterior tissue elasticity change (parameter 3) after surgery versus its pre-surgery value.
Figure 2.
Figure 2.
Posterior tissue elasticity change (parameter 4) after surgery versus its pre-surgery value.
Figure 3.
Figure 3.
Posterior Level II pelvic support (parameter 17) change after surgery versus its pre-surgery value.
Figure 4.
Figure 4.
Posterior Level I pelvic support (parameter 18) change after surgery versus its pre-surgery value.
Figure 5.
Figure 5.
Muscle contractive strength (parameter 28) change after surgery versus its pre-surgery value (Valsalva maneuver).
Figure 6.
Figure 6.
Muscle contractive strength (parameter 50) change after surgery versus its pre-surgery value (reflex contraction, cough).
Figure 7.
Figure 7.
Involuntary muscle relaxation (parameter 45) change after surgery versus its pre-surgery value.
Figure 8.
Figure 8.
Urethral mobility (parameter 49) change after surgery versus its pre-surgery value (reflex contraction, cough).
See this image and copyright information in PMC

References

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    1. Egorov V, van Raalte H, Sarvazyan A. Vaginal Tactile Imaging. IEEE Trans Biomed Eng. 2010;57(7):1736–1744. - PMC - PubMed
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