A 3D finite element model of uterus support to evaluate mechanisms underlying uterine prolapse formation

Abstract

Uterine prolapse (UP) seriously affects the quality of life and physical and mental health of elderly women, which can easily be caused by ligament injury or intra-abdominal pressure (IAP) increasing. The objective of this manuscript was to study the influence of IAP and ligament injury on uterus and its surrounding ligaments using the finite element method. First, the three-dimensional (3D) models of retroverted uterus and its surrounding ligaments were established, and loads and constraints were set in ABAQUS software, then the stress and deformation of uterine ligaments and uterine displacement were calculated. The study found that the uterine displacement and the stress and deformation of the ligaments increased when IAP and ligament injury increased alone or simultaneously. Then, the stress and sensitivity of the ligaments to the changes of IAP or ligament injury were in the order of uterosacral ligament (USL), broad ligament (BL), cardinal ligament (CL) and round ligament (RL), while the deformation and sensitivity the changes of the ligaments were in the order of BL > RL > USL > CL. Moreover, the ligament injury had a greater influence on the uterus and uterine ligaments than IAP. The results of this study can provide guidance for optimization of surgical scheme of uterus prolapsed in clinic and exploration of pathogenesis.

Keywords:

• Intra-abdominal pressure
• ligament injury
• uterine ligament
• pelvic organ prolapse
• finite element analysis

Authors’ contributions

Jialan Chen contributed to the MRI pictures collection, finite element analysis and manuscript writing. Junfeng Zhang contributed to the 3D geometric modelling. Cuige Yu contributed to the guidance for 3D model and reviewing. All authors have read and approved the manuscript.

Disclosure statement

The authors declare that there are no conflict of interests.

Additional information

Funding

We gratefully acknowledge the support of National Science Foundation of Shaanxi Province (grant number 2020SF-035) and Science and Technology Talent Support Program Shaanxi Provincial People’s Hospital (grant number 2021JY-32).