NUMERICAL SIMULATION OF THE VAGINAL WALL REINFORCE- MENT USING COG THREADS

Resumo

Pelvic floor disorders (PFD), including Pelvic Organ Prolapse (POP), can significantly negatively impact a woman’s daily activities and quality of life. POP is a complex and challenging topic in the medical field. The number of cases of genital prolapse has been on the rise each year, with one in ten women requiring at least one surgical procedure and one in four women in midlife having asymptomatic prolapse. The use of mesh implants to correct prolapses requires knowledge of the mechanical properties of the mesh and vaginal and surrounding tissues so that the type of mesh can be chosen to match the actual resistance of the tissue as closely as possible. Using mesh implants to correct POP has proven less effective, often requiring hospital readmission and further surgery;
an alternative surgical intervention technique using injectable biodegradable cog threads was proposed. Typically used for face-lifting procedures, these threads will be applied to reinforce and correct vaginal wall defects. The application of Finite element analysis (FEA) to this research allows us to personalize and select suitable POP correction techniques and study the effect of alternative reinforcement techniques, pointing to areas experiencing critical levels of stress and strain. The 3D computational model of the vagina will be used to simulate defect repair using cog threads. Through using different vaginal wall properties (i.e., early-stage prolapsed tissue), various conditions of its repair could be simulated: reinforcement with a different number of threads (the density could be adjusted, depending on tissue conditions), different thread geometries (thread diameter, cog type), angle of thread
insertion. The threads we will use in our investigation are commercially available and made of polycaprolactone (PCL).