Finite element analysis of different positions of TVT and TVT-O in the treatment of stress urinary incontinence in elderly women

doi:10.13418/j.issn.1001-165x.2025.1.12

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Chinese Journal of Clinical Anatomy ›› 2025, Vol. 43 ›› Issue (1) : 76-81. DOI: 10.13418/j.issn.1001-165x.2025.1.12

Finite element analysis of different positions of TVT and TVT-O in the treatment of stress urinary incontinence in elderly women

Li Weijun¹, Zhou Yi¹, Wu Jianhui², Chen Lihua³, Liu Haiying⁴, Zhai Lidong¹*

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Abstract

Objective To simulate common sling surgeries for stress urinary incontinence (SUI) in elderly women using finite element analysis methods: tension-free vaginal tape (TVT) and tension-free vaginal tape - obturator (TVT-O), and to evaluate their therapeutic effects at different positions of urethra. Methods A pelvic geometry model was constructed based on magnetic resonance imaging (MRI) images of a woman without pelvic floor diseases. The thinning of elderly vaginal tissue was considered as a reduction in tissue stiffness. Abdominal pressure was applied to simulate valsalva maneuver, and TVT and TVT-O were placed at the proximal, mid-distal, and distal parts of urethra, respectively, to obtain mechanical data. Results The sling at the proximal part of urethra would lead to the α-angle and bladder neck displacement less than normal values. The "funnel" phenomenon disappeared when the sling was located at the proximal and mid-distal parts of urethra, but still existed when located at the distal part; the pressure magnitude between the sling and urethra at different positions was: proximal > mid-distal > distal. Conclusions The sling at the proximal part of urethra (30%) is prone to cause excessive tightness of urethra, leading to postoperative complications, the sling at the distal part of urethra (80%) has poor therapeutic effect, the sling at the mid-distal part of urethra (60%) has a good therapeutic effect and a low incidence of postoperative complications. The placement of TVT at the mid-distal part of urethra should be the preferred surgical method for elderly women with SUI.

Key words

Stress urinary incontinence; / / TVT; / / TVT-O; / / Finite element analysis; / / Biomechanics

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Li Weijun, Zhou Yi, Wu Jianhui, Chen Lihua, Liu Haiying, Zhai Lidong. Finite element analysis of different positions of TVT and TVT-O in the treatment of stress urinary incontinence in elderly women[J]. Chinese Journal of Clinical Anatomy. 2025, 43(1): 76-81 https://doi.org/10.13418/j.issn.1001-165x.2025.1.12

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