College of Science and Engineering, Flinders University, Tonsley, South Australia, Australia.
The Ritchie Centre, Hudson Institute of Medical Research, Clayton, Victoria, Australia.
Neurourol Urodyn. 2019 Nov;38(8):2264-2272. doi: 10.1002/nau.24130. Epub 2019 Aug 6.
Pelvic floor disorders (PFDs) in women are a major public health concern. Current clinical methods for assessing PFDs are either subjective or confounded by interference from intra-abdominal pressure (IAP). This study introduces an intravaginal probe that can determine distributed vaginal pressure during voluntary exercises and measures the degree of vaginal tissue support independent of IAP fluctuations.
An intravaginal probe was fabricated with 18 independent fiber-optic pressure transducers positioned along its upper and lower blades. Continuous pressure measurement along the anterior and posterior vaginal walls during the automated expansion of the probe enabled the resistance of the tissue to be evaluated as a function of displacement, in a manner reflecting the elastic modulus of the tissue. After validation in a simulated vaginal phantom, in vivo measurements were conducted in the relaxed state and during a series of voluntary exercises to gauge the utility of the device in women.
The probe reliably detected variations in the composition of sub-surface material in the vaginal phantom. During in-vivo measurements the probe detected distributed tissue elasticity in the absence of IAP change. In addition, the distribution of pressure along both anterior and posterior vaginal walls during cough, Valsalva and pelvic floor contraction was clearly resolved with a large variation observed between subjects.
Our data highlight the potential for the probe to assess the integrity of the vagina wall and support structures as an integrated functional unit. Further in vivo trials are needed to correlate data with clinical findings to assist in the assessment of PFDs.
女性盆底功能障碍（PFD）是一个主要的公共卫生问题。目前评估 PFD 的临床方法要么是主观的，要么受到腹内压（IAP）干扰。本研究引入了一种阴道内探头，它可以在自愿运动期间确定阴道压力的分布，并在不考虑 IAP 波动的情况下测量阴道组织支撑的程度。
阴道内探头由 18 个独立的光纤压力传感器组成，分布在上部和下部叶片上。在探头自动扩张过程中，对阴道前壁和后壁的连续压力测量使组织的阻力能够作为位移的函数进行评估，这种方式反映了组织的弹性模量。在模拟阴道模型中验证后，在放松状态和一系列自愿运动中进行体内测量，以评估该设备在女性中的实用性。
探头可靠地检测到阴道模型中表面下材料组成的变化。在体内测量中，探头在没有 IAP 变化的情况下检测到分布的组织弹性。此外，在咳嗽、瓦尔萨尔瓦动作和盆底收缩期间，探头清晰地分辨出前壁和后壁的压力分布，并且在不同个体之间观察到了很大的差异。
我们的数据突出了探头作为一个集成的功能单元评估阴道壁和支撑结构完整性的潜力。需要进一步的体内试验来将数据与临床发现相关联，以协助评估 PFD。
