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Cunnane EM, Cunnane CV, Allardyce JM, Croghan SM, Walsh MT, Davis NF, Flood HD, Mulvihill JJE. Mechanical and morphological characterisation of porcine urethras for the assessment of paediatric urinary catheter safety. J Mech Behav Biomed Mater 2023; 143:105923. [PMID: 37270901 DOI: 10.1016/j.jmbbm.2023.105923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/15/2023] [Accepted: 05/20/2023] [Indexed: 06/06/2023]
Abstract
Paediatric urinary catheters are often necessary in critical care settings or to address congenital anomalies affecting the urogenital system. Iatrogenic injuries can occur during the placement of such catheters, highlighting the need for a safety device that can function in paediatric settings. Despite successful efforts to develop devices that improve the safety of adult urinary catheters, no such devices are available for use with paediatric catheters. This study investigates the potential for utilising a pressure-controlled safety mechanism to limit the trauma experienced by paediatric patients during inadvertent inflation of a urinary catheter anchoring balloon in the urethra. Firstly, we establish a paediatric model of the human urethra using porcine tissue by characterising the mechanical and morphological properties of porcine tissue at increasing postnatal timepoints (8, 12, 16 and 30 weeks). We identified that porcine urethras harvested from pigs at postnatal week 8 and 12 exhibit morphological properties (diameter and thickness) that are statistically distinct from adult porcine urethras (postnatal week 30). We therefore utilise urethra tissue from postnatal week 8 and 12 pigs as a model to evaluate a pressure-controlled approach to paediatric urinary catheter balloon inflation intended to limit tissue trauma during inadvertent inflation in the urethra. Our results show that limiting catheter system pressure to 150 kPa avoided trauma in all tissue samples. Conversely, all of the tissue samples that underwent traditional uncontrolled urinary catheter inflation experienced complete rupture. The findings of this study pave the way for the development of a safety device for use with paediatric catheters, thereby alleviating the burden of catastrophic trauma and life changing injuries in children due to a preventable iatrogenic urogenital event.
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Affiliation(s)
- Eoghan M Cunnane
- Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland; School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland.
| | - Connor V Cunnane
- Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland; School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
| | - Joanna M Allardyce
- School of Allied Health, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | | | - Michael T Walsh
- Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland; School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland
| | - Niall F Davis
- Department of Urology, Beaumont Hospital, Dublin, Ireland; Tissue Engineering Research Group, Department of Anatomy and Regenerative Medicine, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland; Department of Surgery, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland
| | - Hugh D Flood
- Class Medical Limited, Unit 1 D, Annacotty Business Park, Co, Limerick, Ireland
| | - John J E Mulvihill
- Biomaterials Cluster, Bernal Institute, University of Limerick, Limerick, Ireland; School of Engineering, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland; Health Research Institute, University of Limerick, Limerick, Ireland.
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2
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Serpilli M, Zitti G, Dellabella M, Castellani D, Maranesi E, Morettini M, Lenci S, Burattini L. A Preliminary Validation of a New Surgical Procedure for the Treatment of Primary Bladder Neck Obstruction Using a Computational Modeling Approach. Bioengineering (Basel) 2021; 8:87. [PMID: 34206356 PMCID: PMC8301152 DOI: 10.3390/bioengineering8070087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/11/2021] [Accepted: 06/15/2021] [Indexed: 01/13/2023] Open
Abstract
A new surgical procedure for the treatment of primary bladder neck obstruction with maintenance of anterograde ejaculation is proposed. In place of monolateral or bilateral bladder neck incision, associated with a loss of ejaculation rate of up to 30%, the new surgical procedure consists of laser drilling the bladder neck with a number of holes and without muscle fiber disruption. The effect of this novel procedure has been studied numerically, with a simplified two-dimensional numerical model of the internal urethral sphincter, varying the position and the number of holes in the fibrotic region of the urethral tissue. Results show an improvement of the urethral sphincter opening by increasing the number of holes, ranging from about 6% to 16% of recovery. Moreover, a non-aligned position of holes positively influences the opening recovery. The concentrations of maximum principal strain and stress have been registered in the proximity of the interface between the physiologic and diseased sphincter, and in those regions where the radial thickness is significantly thinner. The effects on the first five patients have been included in the study, showing improvement in micturition, lower urinary tract symptoms, sustained ejaculatory function, and quality of life.
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Affiliation(s)
- Michele Serpilli
- Department of Civil and Building Engineering, and Architecture, Università Politecnica delle Marche, Via Brecce Biance, 60131 Ancona, Italy; (M.S.); (G.Z.); (S.L.)
| | - Gianluca Zitti
- Department of Civil and Building Engineering, and Architecture, Università Politecnica delle Marche, Via Brecce Biance, 60131 Ancona, Italy; (M.S.); (G.Z.); (S.L.)
| | - Marco Dellabella
- Department of Urology, IRCCS INRCA, 60124 Ancona, Italy; (M.D.); (D.C.); (E.M.)
| | - Daniele Castellani
- Department of Urology, IRCCS INRCA, 60124 Ancona, Italy; (M.D.); (D.C.); (E.M.)
| | - Elvira Maranesi
- Department of Urology, IRCCS INRCA, 60124 Ancona, Italy; (M.D.); (D.C.); (E.M.)
| | - Micaela Morettini
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy;
| | - Stefano Lenci
- Department of Civil and Building Engineering, and Architecture, Università Politecnica delle Marche, Via Brecce Biance, 60131 Ancona, Italy; (M.S.); (G.Z.); (S.L.)
| | - Laura Burattini
- Department of Information Engineering, Università Politecnica delle Marche, 60131 Ancona, Italy;
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3
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Natali AN, Fontanella CG, Todros S, Pavan PG, Carmignato S, Zanini F, Carniel EL. Conformation and mechanics of the polymeric cuff of artificial urinary sphincter. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2020; 17:3894-3908. [PMID: 32987559 DOI: 10.3934/mbe.2020216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The surgical treatment of urinary incontinence is often performed by adopting an Artificial Urinary Sphincter (AUS). AUS cuff represents a fundamental component of the device, providing the mechanical action addressed to urethral occlusion, which can be investigated by computational approach. In this work, AUS cuff is studied with reference to both materials and structure, to develop a finite element model. Materials behavior is investigated using physicochemical and mechanical characterization, leading to the formulation of a constitutive model. Materials analysis shows that AUS cuff is composed by a silicone blister joined with a PET fiber-reinforced layer. A nonlinear mechanical behavior is found, with a higher stiffness in the outer layer due to fiber-reinforcement. The cuff conformation is acquired by Computer Tomography (CT) both in deflated and inflated conditions, for an accurate definition of the geometrical characteristics. Based on these data, the numerical model of AUS cuff is defined. CT images of the inflated cuff are compared with results of numerical analysis of the inflation process, for model validation. A relative error below 2.5% was found. This study is the first step for the comprehension of AUS mechanical behavior and allows the development of computational tools for the analysis of lumen occlusion process. The proposed approach could be adapted to further fluid-filled cuffs of artificial sphincters.
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Affiliation(s)
- Arturo Nicola Natali
- Department of Industrial Engineering, University of Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Chiara Giulia Fontanella
- Department of Industrial Engineering, University of Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Silvia Todros
- Department of Industrial Engineering, University of Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Piero G Pavan
- Department of Industrial Engineering, University of Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Simone Carmignato
- Centre for Mechanics of Biological Materials, University of Padova, Italy
- Department of Management and Engineering, University of Padova, Italy
| | - Filippo Zanini
- Department of Management and Engineering, University of Padova, Italy
| | - Emanuele Luigi Carniel
- Department of Industrial Engineering, University of Padova, Italy
- Centre for Mechanics of Biological Materials, University of Padova, Italy
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Marziale L, Lucarini G, Mazzocchi T, Ricotti L, Menciassi A. Comparative analysis of occlusion methods for artificial sphincters. Artif Organs 2020; 44:995-1005. [PMID: 32216102 DOI: 10.1111/aor.13684] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 02/25/2020] [Accepted: 03/19/2020] [Indexed: 12/19/2022]
Abstract
An artificial sphincter is a device that replaces the function of the biological sphincter by occluding the relative biological lumen. The investigation of occlusion methods for artificial sphincters is crucial for a reliable and effective design of such devices. The compression induced onto the tissue by a certain pressure depends on the biomechanical and physiological features of the lumen and on the specific occlusion method. A numerical model and an experimental evaluation are presented here to assess the efficiency of different occlusion methods. Numerical models of circumferential occlusion and clamping occlusion methods to simulate the compression of the biological lumen were developed. Results revealed a relationship between the efficiency of the occlusion method and the physiological condition of the lumen. With differences related to the testing setup, this relationship was also confirmed experimentally by conducting tests on biological simulators. We analyzed the occlusion method to adopt as the physiological pressure (ie, leakage pressure values) changed. In particular, we focused on the urinary incontinence, which is a dysfunction involving the external sphincter surrounding the urethra. In this scenario, we demonstrated that a clamping occlusion is an efficient method to compress the urethra, whose physiological pressures range between 4 and 12 kPa. The clamping occlusion method resulted up to 35% more efficient in terms of sealing pressure than the circumferential one for a closing pressure varying between 2.3 and 11.5 kPa.
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Affiliation(s)
- Leonardo Marziale
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Gioia Lucarini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Tommaso Mazzocchi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Pontedera, Italy
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Marziale L, Lucarini G, Mazzocchi T, Gruppioni E, Castellano S, Davalli A, Sacchetti R, Pistolesi D, Ricotti L, Menciassi A. Artificial Sphincters to Manage Urinary Incontinence: A Review. Artif Organs 2018; 42:E215-E233. [DOI: 10.1111/aor.13164] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 03/16/2018] [Accepted: 03/28/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Leonardo Marziale
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | - Gioia Lucarini
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | - Tommaso Mazzocchi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | | | - Simona Castellano
- Prothesis Center INAIL, Via Rabuina, Vigoroso di Budrio; Bologna Italy
| | - Angelo Davalli
- Prothesis Center INAIL, Via Rabuina, Vigoroso di Budrio; Bologna Italy
| | - Rinaldo Sacchetti
- Prothesis Center INAIL, Via Rabuina, Vigoroso di Budrio; Bologna Italy
| | | | - Leonardo Ricotti
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
| | - Arianna Menciassi
- The BioRobotics Institute, Scuola Superiore Sant'Anna, Viale R. Piaggio, Pontedera; Pisa Italy
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Experimental characterization and constitutive modeling of the biomechanical behavior of male human urethral tissues validated by histological observations. Biomech Model Mechanobiol 2018; 17:939-950. [PMID: 29380159 DOI: 10.1007/s10237-018-1003-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 01/12/2018] [Indexed: 10/18/2022]
Abstract
This work aims at observing the mechanical behavior of the membranous and spongy portions of urethrae sampled on male cadavers in compliance with French regulations on postmortem testing, in accordance with the Scientific Council of body donation center of Grenoble. In this perspective, a thermostatic water tank was designed to conduct ex vivo planar tension tests in a physiological environment, i.e., in a saline solution at a temperature of [Formula: see text] [Formula: see text]. In order to observe the anisotropy of the tissues, the samples were tested in two directions. Tests consisting of a series of load-unload cycles of increasing amplitudes were performed to highlight their viscous behavior. The results were then discussed according to the microstructure of tissue, which was investigated using different staining methods and histological analysis. The observed behaviors were then fitted using an anisotropic hyperelastic or a visco-hyperelastic matrix-fiber model.
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Natali AN, Carniel EL, Frigo A, Fontanella CG, Rubini A, Avital Y, De Benedictis GM. Experimental investigation of the structural behavior of equine urethra. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2017; 141:35-41. [PMID: 28241967 DOI: 10.1016/j.cmpb.2017.01.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 01/17/2017] [Accepted: 01/17/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND AND OBJECTIVE An integrated experimental and computational investigation was developed aiming to provide a methodology for characterizing the structural response of the urethral duct. The investigation provides information that are suitable for the actual comprehension of lower urinary tract mechanical functionality and the optimal design of prosthetic devices. METHODS Experimental activity entailed the execution of inflation tests performed on segments of horse penile urethras from both proximal and distal regions. Inflation tests were developed imposing different volumes. Each test was performed according to a two-step procedure. The tubular segment was inflated almost instantaneously during the first step, while volume was held constant for about 300s to allow the development of relaxation processes during the second step. Tests performed on the same specimen were interspersed by 600s of rest to allow the recovery of the specimen mechanical condition. Results from experimental activities were statistically analyzed and processed by means of a specific mechanical model. Such computational model was developed with the purpose of interpreting the general pressure-volume-time response of biologic tubular structures. The model includes parameters that interpret the elastic and viscous behavior of hollow structures, directly correlated with the results from the experimental activities. RESULTS Post-processing of experimental data provided information about the non-linear elastic and time-dependent behavior of the urethral duct. In detail, statistically representative pressure-volume and pressure relaxation curves were identified, and summarized by structural parameters. Considering elastic properties, initial stiffness ranged between 0.677 ± 0.026kPa and 0.262 ± 0.006kPa moving from proximal to distal region of penile urethra. Viscous parameters showed typical values of soft biological tissues, as τ1=0.153±0.018s, τ2=17.458 ± 1.644s and τ1=0.201 ± 0.085, τ2= 8.514 ± 1.379s for proximal and distal regions respectively. DISCUSSION A general procedure for the mechanical characterization of the urethral duct has been provided. The proposed methodology allows identifying mechanical parameters that properly express the mechanical behavior of the biological tube. The approach is especially suitable for evaluating the influence of degenerative phenomena on the lower urinary tract mechanical functionality. The information are mandatory for the optimal design of potential surgical procedures and devices.
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Affiliation(s)
- Arturo Nicola Natali
- Department of Industrial Engineering, University of Padova, Via Venezia 1, I-35131 Padova Italy; Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Emanuele Luigi Carniel
- Department of Industrial Engineering, University of Padova, Via Venezia 1, I-35131 Padova Italy; Centre for Mechanics of Biological Materials, University of Padova, Italy.
| | - Alessandro Frigo
- Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Chiara Giulia Fontanella
- Centre for Mechanics of Biological Materials, University of Padova, Italy; Department of Biomedical Sciences, University of Padova, Italy
| | - Alessandro Rubini
- Centre for Mechanics of Biological Materials, University of Padova, Italy; Department of Biomedical Sciences, University of Padova, Italy
| | - Yochai Avital
- Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Giulia Maria De Benedictis
- Centre for Mechanics of Biological Materials, University of Padova, Italy; Department of Animal Medicine, Production and Health, University of Padova, Italy
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8
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Urethral lumen occlusion by artificial sphincteric devices: a computational biomechanics approach. Biomech Model Mechanobiol 2017; 16:1439-1446. [PMID: 28343260 DOI: 10.1007/s10237-017-0897-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 03/14/2017] [Indexed: 10/19/2022]
Abstract
The action induced by artificial sphincteric devices to provide urinary continence is related to the problem of evaluating the interaction between the occlusive cuff and the urethral duct. The intensity and distribution of the force induced within the region of application determine a different occlusion process and potential degradation of the urethral tissue, mostly at the borders of the cuff. This problem is generally considered in the light of clinical and surgical operational experience, while a valid cooperation is established with biomechanical competences by means of experimental and numerical investigation. A three-dimensional model of the urethra is proposed aiming at a representation of the phases of the urethral occlusion through artificial sphincters. Different conformations of the cuff are considered, mimicking different loading conditions in terms of force intensity and distribution and consequent deformation caused in soft tissues. The action induced in the healthy urethra is investigated, as basis for an evaluation of the efficacy and reliability of the sphincteric devices. The problem is characterized by coupled nonlinear geometric and material problem and entails a complex constitutive formulation. A heavy computational procedure is developed by means of analyses that operate within an explicit finite element formulation. Results reported outline the overall response of the urethral duct during lumen occlusion, leading to an accurate description of the phenomenon in the different phases.
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Natali AN, Carniel EL, Fontanella CG, Frigo A, Todros S, Rubini A, De Benedictis GM, Cerruto MA, Artibani W. Mechanics of the urethral duct: tissue constitutive formulation and structural modeling for the investigation of lumen occlusion. Biomech Model Mechanobiol 2016; 16:439-447. [DOI: 10.1007/s10237-016-0828-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Accepted: 08/31/2016] [Indexed: 11/30/2022]
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10
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Natali AN, Carniel EL, Frigo A, Pavan PG, Todros S, Pachera P, Fontanella CG, Rubini A, Cavicchioli L, Avital Y, De Benedictis GM. Experimental investigation of the biomechanics of urethral tissues and structures. Exp Physiol 2016; 101:641-56. [PMID: 26864993 DOI: 10.1113/ep085476] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 02/04/2016] [Indexed: 12/20/2022]
Abstract
NEW FINDINGS What is the central question of this study? Prostheses for treatment of urinary incontinence elicit complications associated with an inadequate mechanical action. This investigation aimed to define a procedure addressed to urethral mechanical characterization. Experimental tests are the basis for constitutive formulation, with a view to numerical modelling for investigation of the interaction between the tissues and a prosthesis. What is the main finding and its importance? Horse urethra, selected for its histomorphometric similarity to human urethra, was characterized by integrated histological analysis and mechanical tests on the biological tissue and structure, leading to constitutive formulation. A non-linear, anisotropic and time-dependent response was found, representing a valid basis for development of a numerical model to interpret the functional behaviour of the urethra. Urinary dysfunction can lead to incontinence, with an impact on the quality of life. Severe dysfunction can be overcome surgically by the use of an artificial urinary sphincter. Nonetheless, several complications may result from inappropriate functioning of the prosthesis, in many instances resulting from an unsuitable mechanical action of the device on the urethral tissues. Computational models allow investigation of the mechanical interaction between biological tissues and biomedical devices, representing a potential support for surgical practice and prosthesis design. The development of such computational tools requires experimental data on the mechanics of biological tissues and structures, which are rarely reported in the literature. The aim of this study was to provide a procedure for the mechanical characterization of urethral tissues and structures. The experimental protocol included the morphometric and histological analysis of urethral tissues, the mechanical characterization of the response of tissues to tensile and stress-relaxation tests and evaluation of the behaviour of urethral structures by inflation tests. Results from the preliminary experiments were processed, adopting specific model formulations, and also providing the definition of parameters that characterize the elastic and viscous behaviour of the tissues. Different experimental protocols, leading to a comprehensive set of experimental data, allow for a reciprocal assessment of reliability of the investigation approach.
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Affiliation(s)
- Arturo Nicola Natali
- Department of Industrial Engineering, University of Padova, Italy.,Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Emanuele Luigi Carniel
- Department of Industrial Engineering, University of Padova, Italy.,Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Alessandro Frigo
- Department of Industrial Engineering, University of Padova, Italy.,Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Piero Giovanni Pavan
- Department of Industrial Engineering, University of Padova, Italy.,Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Silvia Todros
- Department of Industrial Engineering, University of Padova, Italy.,Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Paola Pachera
- Department of Industrial Engineering, University of Padova, Italy.,Centre for Mechanics of Biological Materials, University of Padova, Italy
| | - Chiara Giulia Fontanella
- Centre for Mechanics of Biological Materials, University of Padova, Italy.,Department of Biomedical Sciences, University of Padova, Italy
| | - Alessandro Rubini
- Centre for Mechanics of Biological Materials, University of Padova, Italy.,Department of Biomedical Sciences, University of Padova, Italy
| | - Laura Cavicchioli
- Department of Comparative Biomedicine and Food Science, University of Padova, Italy
| | - Yochai Avital
- Department of Animal Medicine, Production and Health, University of Padova, Italy
| | - Giulia Maria De Benedictis
- Centre for Mechanics of Biological Materials, University of Padova, Italy.,Department of Animal Medicine, Production and Health, University of Padova, Italy
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Paya AS, Fernandez DR, Gil D, Garcia Chamizo JM, Perez FM. Mathematical modelling of the lower urinary tract. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2013; 109:323-338. [PMID: 23107160 DOI: 10.1016/j.cmpb.2012.09.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 09/14/2012] [Accepted: 09/15/2012] [Indexed: 06/01/2023]
Abstract
The lower urinary tract is one of the most complex biological systems of the human body as it involved hydrodynamic properties of urine and muscle. Moreover, its complexity is increased to be managed by voluntary and involuntary neural systems. In this paper, a mathematical model of the lower urinary tract it is proposed as a preliminary study to better understand its functioning. Furthermore, another goal of that mathematical model proposal is to provide a basis for developing artificial control systems. Lower urinary tract is comprised of two interacting systems: the mechanical system and the neural regulator. The latter has the function of controlling the mechanical system to perform the voiding process. The results of the tests reproduce experimental data with high degree of accuracy. Also, these results indicate that simulations not only with healthy patients but also of patients with dysfunctions with neurological etiology present urodynamic curves very similar to those obtained in clinical studies.
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Affiliation(s)
- Antonio Soriano Paya
- Computing Technology and Data Processing, University of Alicante, Carretera San Vicente del Raspeig s/n, San Vicente del Raspeig, 03690 Alicante, Spain
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12
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Valerio M, Jichlinski P, Dahlem R, Tozzi P, Mundy AR. Experimental evaluation of an electromechanical artificial urinary sphincter in an animal model. BJU Int 2013; 112:E337-43. [DOI: 10.1111/j.1464-410x.2012.11728.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Massimo Valerio
- Department of Urology; Centre Hospitalier Universitaire Vaudois; Lausanne; Switzerland
| | - Patrice Jichlinski
- Department of Urology; Centre Hospitalier Universitaire Vaudois; Lausanne; Switzerland
| | - Roland Dahlem
- Department of Urology; University Hospital Hamburg-Eppendorf; Hamburg-Eppendorf; Germany
| | - Piergiorgio Tozzi
- Cardiovascular Surgery Department; Centre Hospitalier Universitaire Vaudois; Lausanne; Switzerland
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