Biomechanics of the Female Pelvic Floor, Second Edition, is the first book to specifically focus on this key part of women’s health, combining engineering and clinical expertise. This edited collection will help readers understand the risk factors for pelvic floor dysfunction, the mechanisms of childbirth related injury, and how to design intrapartum preventative strategies, optimal repair techniques, and prostheses. The authors have combined their expertise to create a thorough, comprehensive view of female pelvic floor biomechanics in order to help different disciplines discuss, research, and drive solutions to pressing problems. The book includes a common language for the design, conduct, and reporting of research studies in female PFD, and will be of interest to biomechanical and prosthetic tissue engineers and clinicians interested in female pelvic floor dysfunction, including urologists, urogynecologists, maternal fetal medicine specialists, and physical therapists. Contains contributions from leading bioengineers and clinicians, and provides a cohesive multidisciplinary view of the field Covers causes, risk factors, and optimal treatment for pelvic floor biomechanics Combines anatomy, imaging, tissue characteristics, and computational modeling development in relation to pelvic floor biomechanics

The second stage of labour is the primary cause of levator ani (LA) muscle injury, which is in turn the leading factor contributing to pelvic floor disorders including pelvic organ prolapse and urinary stress incontinence. Understanding the mechanics of vaginal delivery is important for the development of preventative strategies for such disorders. This thesis presents a finite element (FE) biomechanical modelling framework to quantitatively analyse the mechanics of the second stage of labour. This childbirth model will enable the identification of potential risk factors that are associated with a difficult labour and LA muscle injuries. Anatomically realistic, individual-specific FE models were constructed from medical images of 26 nulliparous healthy female volunteers and 28 newborn infants. The models of the pelvic floor included the LA muscles, part of the obturator internus muscles, external sphincter muscles, perineal body, superficial anococcygeal ligament, and full bony pelvis. The models of the fetal head represented the vault that comes into direct contact with the pelvic floor during labour. Statistical shape analyses were conducted on these models and the primary shape variations are presented with reference to clinically important parameters. A new modelling framework of the second stage of labour was created based on an existing model. Additional anatomical structures, including the bony pelvis, external sphincter muscle, perineal body, and superficial anococcygeal ligament, were incorporated to provide more complete constraints for the deformation of the levator ani (LA) muscles and fetal head motion. Through a series of biomechanical simulations, it was found that the presence of the perineal body, external sphincter muscles, and inferior pubic rami played important roles in the mechanics of vaginal delivery. The effects of the mechanical properties of pelvic floor structures were investigated by altering the constitutive parameters of the pelvic floor within their physiological ranges of values. It was shown that the mechanical properties of the pelvic floor muscles influenced the delivery forces and the distributions of the maximum principal stretch ratios significantly. The largest maximum principal stretch ratios occurred at the anterior LA muscle- pubis insertions where injuries are most frequently observed clinically. The modelling framework was then applied to explore the effects of shape variations in the pelvic floor and fetal head on the maximum force required by delivery. Several features of the pelvic floor, including a reduction in the area of the levator hiatus, a constriction in the subpubic angle, a decrease in angle between the coccyx and the axial plane, and an increase in the size of the fetal head, increased the maximum delivery force substantially. Statistical regression models were also constructed to demonstrate the feasibility of generating approximations of childbirth simulations using fetal head geometries as input. With further development, such models could take both the pelvic floor and fetal head geometries as input and could be implemented in a clinical setting as a predictive model for childbirth planning.

This book focuses on particular mental and physical aspects of women’s health, presenting topics concerning the pelvis and pelvic floor dysfunction and the breast during a woman’s life, such as rehabilitation for pelvic and breast disorders, and the benefits of biomechanical analysis in treating these conditions. With each chapter providing a brief survey of a major research area related to the theme, the book offers an integrated overview of topics such as the bio-psycho-social model of women’s health, pelvic floor evaluation in sports, the breast, pregnancy and delivery. It is a valuable resource for a wide range of readers, including researchers, graduates and professionals.

This excellent textbook provides up-to-date information on all aspects of pelvic floor disorders. After an opening section on anatomy and physiology, it explains the methodology, role and application of the integrated imaging approach in detail, including the most advanced 3D, 4D, and dynamic ultrasound techniques, illustrated with hundreds of images. It then discusses in depth the epidemiology, etiology, assessment, and management of the full range of pelvic floor disorders from multidisciplinary and practical perspectives. The book also provides information on the various forms of obstetric perineal trauma, urinary incontinence and voiding dysfunction, anal incontinence, pelvic organ prolapse, constipation and obstructed defecation, pelvic pain and sexual dysfunction, and fistulas, and includes treatment algorithms as well as helpful guidance on what to do when surgical treatment goes wrong. The authors are leading experts in the field from around the globe. Since the first edition from 2010 (more than 200,000 chapter downloads), the book has been extensively rewritten and features numerous additional topics. The result is a comprehensive textbook that is invaluable for gynecologists, colorectal surgeons, urologists, radiologists, and gastroenterologists, beginners and veterans alike.

This book contains contributions from computational biomechanics specialists who present and exchange opinions on the opportunities for applying their techniques to computer-integrated medicine, including computer-aided surgery and diagnostic systems. Computational Biomechanics for Medicine collects peer-reviewed chapters from the annual Computational Biomechanics for Medicine Workshop, in conjunction with the Medical Image Computing and Computer Assisted Intervention [MICCAI] Society conference. The works are dedicated to research in the field of methods and applications of computational biomechanics to medical image analysis, image-guided surgery, surgical simulation, surgical intervention planning, disease diagnosis and prognosis, analysis of injury mechanisms, implant and prosthesis design, artificial organ design, and medical robotics. These chapters will appeal to a wide range of researchers and students within the fields of engineering and medicine, as well as those working in computational science.