A finite element analysis of different postures and intra-abdominal pressures for the uterine ligaments in maintaining the normal position of uterus

Abstract

Uterine prolapse is a common gynecological disease, which seriously affects the quality of life and physical and mental health of elderly women. The aim of this study was to analyze the influence of different conditions (intra-abdominal pressure (IAP) and posture) on stress and displacement of uterine ligaments using the finite element method, and evaluate the contribution of uterine ligaments on uterus. The three-dimensional (3D) models of retroverted uterus and its accessory ligaments were established, loads and constraints were set in ABAQUS software, and the stress and displacement of uterine ligaments were calculated. The uterine displacement increased with the increase of IAP, and then the stress and displacement of each uterine ligament also increased. The uterine displacement was in the order of forward < upright < backward with different postures, and USL, CL and RL got larger values when the body was backward, while BL got a larger value when the body was forward. With the same condition, the stress of the uterine ligaments was in the order of USL > BL > CL > RL, and the displacement of the ligaments was in the order of BL > RL > USL > CL. The contribution of each uterine ligament changing with different IAP and postures was studied through finite element analysis, and the research results were consistent with the clinical data, which can provide a basis for exploring the mechanism of uterine prolapse.

Finite element analysis of female pelvic organ prolapse mechanism: current landscape and future opportunities

“…Chen et al specifically developed a FE model to simulate the uterus and its associated ligaments in order to evaluate the mechanical alterations of these ligaments under varying positions and intra-abdominal pressure ( 47 ). This study developed one of the most comprehensive FE models to date, encompassing the uterus and its associated ligaments, thereby further substantiating the pivotal role played by uterosacral ligaments (USL) and cardinal ligaments (CL) in upholding uterine biomechanical stability.…”

“…The Yeoh model, a reduced-order polynomial model derived from the Mooney-Rivlin model, accurately predicts the anisotropic, incompressible, and non-linear behavior of soft tissues. Presently, it stands as the most widely employed model for FE analysis of diverse pelvic diseases ( 47 , 65 , 66 ). The material in this model is defined as being composed of embedded fibers that tend to be dynamically activated over time under appropriate loads ( 67 ).…”