Shaked Sivan, Jaffa Ariel J, Grisaru Dan, Elad David
Department of Biomedical Engineering, Faculty of Engineering, Tel Aviv University, 69978, Tel Aviv, Israel.
Biomech Model Mechanobiol. 2015 Jun;14(3):437-44. doi: 10.1007/s10237-014-0614-4. Epub 2014 Sep 13.
Adenomyosis is a disease in which ectopic endometrial glands and stromal cells appear in the uterine myometrium. This pathology is common among women of reproductive age, and in addition to chronic pelvic pain and heavy periods it may also cause infertility. The 'tissue injury and repair' mechanism in response to increased intrauterine pressures was proposed as the etiology for migration of fragments of basal endometrium into the myometrial wall. In order to investigate this mechanism, a conceptual two-dimensional model of the uterine wall subjected to intrauterine pressures was implemented using ADINA commercial software. The stress field within the uterine wall was examined for a variety of intrauterine sinusoidal pressure waves with varying frequencies. The results revealed that: (1) as the wavelength of the subjected pressure wave decreased, high concentration of stresses developed near the inner uterine cavity; (2) as the pressure wave frequency increased, high gradients of the stresses were obtained; (3) at menstrual phase, the highest stresses obtained at the endometrial-myometrial interface. Therefore, increased uterine activity results in high stresses which may lead to tissue lesions and detachment of endometrial cells.
子宫腺肌病是一种异位子宫内膜腺体和间质细胞出现在子宫肌层的疾病。这种病理情况在育龄女性中很常见，除了慢性盆腔疼痛和月经过多外，它还可能导致不孕。“组织损伤与修复”机制被认为是子宫内压力增加导致基底层子宫内膜碎片迁移到肌层壁的病因。为了研究这一机制，使用ADINA商业软件建立了一个子宫壁承受子宫内压力的二维概念模型。研究了子宫壁内的应力场，考察了各种频率不同的子宫内正弦压力波。结果表明：（1）随着所施加压力波波长的减小，子宫内腔附近出现高应力集中；（2）随着压力波频率的增加，应力梯度增大；（3）在月经期，子宫内膜-肌层界面处的应力最高。因此，子宫活动增加会导致高应力，这可能会导致组织损伤和子宫内膜细胞脱落。
