Real-time measurement of the vaginal pressure profile using an optical-fiber-based instrumented speculum

Abstract

Pelvic organ prolapse (POP) occurs when changes to the pelvic organ support structures cause descent or herniation of the pelvic organs into the vagina. Clinical evaluation of POP is a series of manual measurements known as the pelvic organ prolapse quantification (POP-Q) score. However, it fails to identify the mechanism causing POP and relies on the skills of the practitioner. We report on a modified vaginal speculum incorporating a double-helix fiber-Bragg grating structure for distributed pressure measurements along the length of the vagina and include preliminary data in an ovine model of prolapse. Vaginal pressure profiles were recorded at 10 Hz as the speculum was dilated incrementally up to 20 mm. At 10-mm dilation, nulliparous sheep showed higher mean pressures ( 102 ± 46 ?? mmHg ) than parous sheep ( 39 ± 23 ?? mmHg ) ( P = 0.02 ), attributable largely to the proximal (cervical) end of the vagina. In addition to overall pressure variations, we observed a difference in the distribution of pressure that related to POP-Q measurements adapted for the ovine anatomy, showing increased tissue laxity in the upper anterior vagina for parous ewes. We demonstrate the utility of the fiber-optic instrumented speculum for rapid distributed measurement of vaginal support.

Ovine multiparity is associated with diminished vaginal muscularis, increased elastic fibres and vaginal wall weakness: implication for pelvic organ prolapse

“…1A). Ovine vaginal wall weakness was also measured with a novel pressure sensor device15, which has eight fibre optic pressure sensors inserted 10 mm apart on each of the anterior and posterior blades of a modified speculum that enables the measurement of distributed pressure along both the posterior and anterior vaginal wall (Fig. 1B).…”

“…However, this novel device holds value in that it is capable of measuring alterations in pressure along the lengths of the anterior and posterior vaginal wall, instead of a single measurement for both. This may be achieved by automating dilation of the speculum to minimise movement artefact and determining the maximum rate of pressure change versus dilation to accommodate variations in vaginal dimensions that may be associated with parity or vaginal weakness15.…”

“…Similar to women, ewes develop spontaneous POP1314, but the pathophysiological mechanisms that underpin POP are not well understood. We have therefore developed a novel pressure sensor device to detect changes in vaginal wall pressures along the length of the anterior and posterior walls to better diagnose weakened regions that might be associated with POP15. In addition, we have adapted the pelvic organ prolapse quantification (POP-Q) system, a clinical score of POP for assessing the ewe vagina16.…”

A fiber‐optic sensor‐based device for the measurement of vaginal integrity in women

“…The fiber‐optic sensor arrays used were adapted from the devices developed for measuring pressure beneath compression bandages . The mode of operation of these devices has been described in detail elsewhere …”

Análise da distribuição multivetorial de cargas do assoalho pélvico feminino em diferentes populações

“…Most authors suggest assessing PFM strength using vaginal dynamometers, considering it a better method as they measure force directly Verelst and Leivseth 2004a;Saleme et al 2009;Nunes et al 2011;Ashton-Miller et al 2014;Parkinson et al 2016;Romero-Cullerés et al 2017). However, none of the aforementioned dynamometer prototypes are available to be commercialized, and they appear to be used only in a research scenario.…”