Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland Clinic Main Campus, Mail Code ND20, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Ann Biomed Eng. 2013 Jan;41(1):185-94. doi: 10.1007/s10439-012-0637-x. Epub 2012 Aug 21.
Stress urinary incontinence is a condition that affects mainly women and is characterized by the involuntary loss of urine in conjunction with an increase in abdominal pressure but in the absence of a bladder contraction. In spite of the large number of women affected by this condition, little is known regarding the mechanics associated with the maintenance of continence in women. Urodynamic measurements of the pressure acting on the bladder and the pressures developed within the bladder and the urethra offer a potential starting point for constructing computational models of the bladder and urethra during stress events. The measured pressures can be utilized in these models to provide information to specify loads and validate the models. The main goals of this study were to investigate the feasibility of incorporating human urodynamic pressure data into a computational model of the bladder and the urethra during a cough and determine if the resulting model could be validated through comparison of predicted and measured vesical pressure. The results of this study indicated that simplified models can predict vesical pressures that differ by less than 5 cmH(2)O (<10%) compared to urodynamic pressure measurements. In addition, varying material properties had a minimal impact on the vesical pressure and displacements predicted by the model. The latter finding limits the use of vesical pressure as a validation criterion since different parameters can yield similar results in the same model. However, the insensitivity of vesical pressure predictions to material properties ensures that the outcome of our models is not highly sensitive to tissue material properties, which are not well characterized.
压力性尿失禁主要影响女性，其特征是在腹部压力增加的情况下出现无意识的尿液流失，但膀胱没有收缩。尽管有大量女性受到这种情况的影响，但对于维持女性尿失禁的机制知之甚少。对膀胱施加的压力和膀胱内及尿道内产生的压力的尿动力学测量为构建压力事件期间膀胱和尿道的计算模型提供了一个潜在的起点。可以在这些模型中利用测量的压力来提供信息以指定载荷并验证模型。本研究的主要目标是研究在咳嗽期间将人体尿动力学压力数据纳入膀胱和尿道计算模型的可行性，并确定所得到的模型是否可以通过比较预测和测量的膀胱压力进行验证。这项研究的结果表明，与尿动力学压力测量相比，简化模型可以预测出差异小于 5cmH2O（<10%）的膀胱压力。此外，材料特性的变化对模型预测的膀胱压力和位移的影响最小。后一种发现限制了将膀胱压力用作验证标准，因为不同的参数在相同的模型中可以产生相似的结果。然而，膀胱压力预测对材料特性的不敏感性确保了我们模型的结果不受组织材料特性的高度影响，而这些特性尚未得到很好的描述。
