ECCOMAS 2024

Vaginal wall reinforcement with cog threads using numerical methods

  • Ferreira, Nuno Miguel (LAETA-INEGI)
  • Silva, Elisabete (LAETA-INEGI)
  • Fernandes, António (FEUP)

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Pelvic Organ Prolapse (POP) is a medical condition that impacts the quality of life of women [1]. The incidence of genital prolapse has been increasing annually, with one out of every ten women requiring a surgical procedure and a quarter of women in midlife having asymptomatic prolapse, necessitating the development of innovative treatment approaches. Although traditional mesh implants are frequently used, they have certain limitations[2], indicating the need for alternate solutions. This research investigates the use of biodegradable cog threads, which are typically employed in facelift procedures, to strengthen and correct vaginal wall defects resulting from POP. To model the vaginal wall and simulate the repair of defects using cog threads, finite element analysis (FEA) was utilized. The application of FEA to this study enables us to personalize and choose appropriate POP correction techniques while also investigating the impact of alternate reinforcement approaches, highlighting regions that are experiencing critical levels of stress and strain. To accurately model this, we conducted uniaxial tensile tests on both the polycaprolactone (PCL) cog threads and pork vaginal tissues, which served as a human tissue analogue, providing vital data for precise finite element modelling. We utilized Abaqus 2022 to perform FEM simulations. In addition, we conducted ball burst tests to examine the interaction between cog threads and free-standing pork vaginal tissues under spherical indentation, closely mimicking in vivo conditions. By combining experimental testing with numerical simulation, we were able to thoroughly analyse the interaction between the thread and tissue. The findings of the study suggest that cog threads have the potential to provide benefits in the treatment of pelvic organ prolapse (POP). This research lays the groundwork for further exploration of the use of cog threads for the treatment of POP. It also emphasizes the superiority of cog threads over traditional mesh implants in terms of shorter surgical time, improved recovery, and reduced complication rates. Due to the nature of soft tissues, the understanding and interpretation of parameter fittings related to the experimental data are difficult.