Novel instrumented probe for measuring 3D pressure distribution along the vaginal canal

Author(s)

Cacciari, Licia P. ; Passaro, Anice C. ; Amorim, Amanda C. ; Geuder, Manfred ; Sacco, Isabel C. N.

• Document type: Journal article
• Source: JOURNAL OF BIOMECHANICS; v. 58, p. 139-146, JUN 14 2017.
• Web of Science Citations: 4

Abstract

We developed an intravaginal instrumented probe (covered with a 10 x 10 matrix of capacitive sensors) for assessing the three-dimensional (3D) spatiotemporal pressure profile of the vaginal canal. The pressure profile was compared to the pelvic floor (PF) digital assessment, and the reliability of the instrument and repeatability of the protocol was tested. We also tested its ability to characterize and differentiate two tasks: PF maximum contraction and Valsalva maneuver (maximum intra-abdominal effort with downward movement of the PF). Peak pressures were calculated for the total matrix, for three major sub-regions, and for 5 planes and 10 rings throughout the vaginal canal. Intraclass correlation coefficients indicated excellent inter- and intra-rater reliability and intra-trial repeatability for the total and medial areas, with moderate reliability for the cranial and caudal areas. There was a moderate correlation between peak pressure and PF digital palpation {[}Spearman's coefficient r = 0.55 (p < 0.001)]. Spatiotemporal profiles were completely different between tasks (2-way ANOVAs for repeated measures) with notably higher pressures (above 30 kPa) for the maximum contraction task compared to Valsalva (below 15 kPa). At maximum contraction, higher pressures occurred in the mid-antero-posterior zone, with earlier peak pressure onsets and more variable along the vaginal depth (from rings 3 to 10 caudal). During Valsalva, the highest pressures were observed in rings 4-6, with peak pressure onsets more synchronized between rings. With this protocol and novel instrument, we obtained a high resolution and highly reliable innovative 3D pressure distribution map of the PF capable of distinguishing vaginal sub-regions, planes, rings and tasks. (C) 2017 Elsevier Ltd. All rights reserved. (AU)

• FAPESP's process: 13/19610-3 - Multivetorial load of the pelvic floor of different women populations
• Grantee: Isabel de Camargo Neves Sacco
• Support Opportunities: Regular Research Grants
• FAPESP's process: 15/19679-9 - Alterações morfológicas do assoalho pélvico decorrentes do tratamento fisioterapêutico para incontinência urinaria medidas por meio do ultrassom transperineal
• Grantee: Licia Pazzoto Cacciari
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 13/13820-6 - The influence of perineal training and type of delivery on multidirectional load distribution of the female pelvic floor
• Grantee: Licia Pazzoto Cacciari
• Support Opportunities: Scholarships in Brazil - Doctorate