Fig 1.
Simulation of posterior sacrospinous ligament fixation with the generic model.
(a) Generic model of the pelvic organs (front and sagittal views), (b) Surgical modeling of right and left posterior sacrospinous ligament fixation (front and sagittal views).
Table 1.
Steps to obtain a patient-specific finite element model of pelvic organ prolapse using the patient’s preoperative’ MRI.
Fig 2.
Construction of a geometric model based on the preoperative patient-specific Magnetic Resonance Imaging (MRI).
(a) Pelvic organ displacement measurements (mm) on the sagittal section of the dynamic MRI under maximum strain using the pubococcygeal line (PCL) method [30]: Pubococcygeal line (pink), anterior compartment (Ba max point), cervix (C max point), posterior compartment (Bp max point). (b) 3D reconstruction of the pelvic system from the patient-specific preoperative MRI.
Fig 3.
Surface reconstruction of the patient-specific model: Top view (a), posterior view (b), sagittal view (c) and front view (d).
Fig 4.
Displacement study of C, Ba and Bp points (mm) under physiological and pathological conditions or according to the distance between the anchorage zone on the sacrospinous ligament and the ischial spine (1 or 2 or 3 cm).
IS: Ischial spine; physio: Physiological conditions; GEN patho: Pathological conditions.
Fig 5.
Asymmetrical pelvic organ mobility according to the patient-specific finite element model before surgery (top anatomical view).
Red arrows: Scheme of the sutures between the vaginal apex and the ischial spine. Colormap: Small displacements in blue and maximum displacements in red.
Fig 6.
Study displacement (mm) of C and Bp points according to a left and/or right SSF and the distance between the anchorage zone and the ischial spine (1cm, 2 cm or 3cm).
WS: Without surgery, both: Bilateral SSF.