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. 2025 Mar 26;24(1):38.
doi: 10.1186/s12938-025-01366-9.

Ex vivo myo-mechanical assessment of isolated rectus abdominis muscle in pregnancy-specific urinary incontinence: a cross-sectional study nested within the Diamater cohort

Carolina N F Carvalho  1 , David R A Reyes  1 , Juliana F Floriano  1 , Sofia B C V Quiroz  1   2 , Rafael G Oliveira  1 , Fernanda C B Alves  1 , Gabriela A Garcia  3 , Luana F Iamundo  1 , Adriely B M Magyori  1 , Caroline B Prudencio  1   4 , Patricia S Rossignoli  5 , Cristiane R Pedroni  5 , Raghavendra L S Hallur  1   6 , Iracema M P Calderon  1 , Angélica M P Barbosa  1   5 , Marilza V C Rudge  7 ; Diamater Study Group
Collaborators, Affiliations

Ex vivo myo-mechanical assessment of isolated rectus abdominis muscle in pregnancy-specific urinary incontinence: a cross-sectional study nested within the Diamater cohort

Carolina N F Carvalho et al. Biomed Eng Online. .

Abstract

Background: Rectus abdominis muscle (RAM) myopathy is the underlying mechanism of pregnancy-specific urinary incontinence (PSUI), which has been shown to be a predictor of long-term urinary incontinence (UI). However, there is limited knowledge about selective ex vivo myo-mechanical assessment (MMA) of the RAM in healthy pregnant women, particularly those with PSUI.

Results: Our analysis revealed no specific quantitative parameters from the window analysis or contractile response of the RAM in ex vivo MMA. A gradual and consistent decline was predominantly observed in the peak and strength parameters for both groups. The qualitative contractile response analysis of the RAM using peak and strength parameters revealed three distinct behaviors under electrical stimulation: a progressive decrease in strength, sudden muscular arrest, and asynchrony with erratic fluctuations. In-depth quantitative analysis of the RAM ex vivo did not yield substantial differences between the two groups. However, qualitative analysis proved valuable in distinguishing the groups, revealing a tendency toward the loss of the progressive peak declines observed in the control group.

Conclusion: This study highlights the complexity of RAM myopathy in the context of PSUI and its potential impact on UI outcomes.

Method: In this cross-sectional study nested within a cohort, we examined ex vivo myography assessments in 87 mothers, comprising 48 with PSUI and 39 without PSUI, all of whom exhibited normal glucose tolerance. General data were extracted from our database, whereas RAM samples were collected during C-section for qualitative and quantitative ex vivo myography analysis, with a focus on initial and final baseline measurements, peak responses, strength, and duration times.

Keywords: Ex vivo myo-mechanical assay; Long-term urinary incontinence; Pregnancy-specific urinary incontinence; Qualitative analysis; Rectus abdominis muscle.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study adhered to the ethical guidelines and regulations outlined in the Declaration of Helsinki and was approved by the research ethics committee of Botucatu Medical School and the National Research Ethics Committee (CONEP) under the registration number CAAE: 82225617.0.0000.5411. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart illustrating participant distribution in each group: control and PSUI
Fig. 2
Fig. 2
A and B Qualitative statistical data of peak and force in the control and PSUI groups. The red arrows indicate regions where there is a change in behavior, although statistically significant differences were not found (p < 0.05); C, E and G represent contraction response vs. applied electrical stimulus in the control group; D, F and H represent contraction response vs. applied electrical stimulus in the PSUI group; I, K and M represent contraction force (peak height) in the control group; and J, L and N represent contraction force (peak height) in the PSUI group
See this image and copyright information in PMC

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