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

Li Weijun, Zhou Yi, Wu Jianhui, Chen Lihua, Liu Haiying, Zhai Lidong

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

2025 , Vol. 43 >Issue 1: 76 - 81

DOI: https://doi.org/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

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1. Department of Anatomy, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China; 2. Department of Urology, Tianjin First Central Hospital, Tianjin 300192, China; 3. Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, China; 4. School of Mechanical Engineering, Tianjin University of Technology, Tianjin 300384, China

Received date: 2024-01-03

Online published: 2025-01-22

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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

Cite this article

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

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