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Abstract The vagina is a viscoelastic fibromuscular organ that provides support to the pelvic organs. The viscoelastic properties of the vagina are understudied but may be critical for pelvic stability. Most studies evaluate vaginal viscoelasticity under a single uniaxial load; however, the vagina is subjected to dynamic multiaxial loading in the body. It is unknown how varied multiaxial loading conditions affect vaginal viscoelastic behavior and which microstructural processes dictate the viscoelastic response. Therefore, the objective was to develop methods using extension-inflation protocols to quantify vaginal viscoelastic creep under various circumferential and axial loads. Then, the protocol was applied to quantify vaginal creep and collagen microstructure in the fibulin-5 wildtype and haploinsufficient vaginas. To evaluate pressure-dependent creep, the fibulin-5 wildtype and haploinsufficient vaginas (n = 7/genotype) were subjected to various constant pressures at the physiologic length for 100 s. For axial length-dependent creep, the vaginas (n = 7/genotype) were extended to various fixed axial lengths then subjected to the mean in vivo pressure for 100 s. Second-harmonic generation imaging was performed to quantify collagen fiber organization and undulation (n = 3/genotype). Increased pressure significantly increased creep strain in the wildtype, but not the haploinsufficient vagina. The axial length did not significantly affect the creep rate or strain in both genotypes. Collagen undulation varied through the depth of the subepithelium but not between genotypes. These findings suggest that the creep response to loading may vary with biological processes and pathologies, therefore, evaluating vaginal creep under various circumferential loads may be important to understand vaginal function. 

The vagina undergoes large finite deformations and has complex geometry and microstructure, resulting in material and geometric nonlinearities, complicated boundary conditions, and nonhomogeneities within finite element (FE) simulations. These nonlinearities pose a significant challenge for numerical solvers, increasing the computational time by several orders of magnitude. Simplifying assumptions can reduce the computational time significantly, but this usually comes at the expense of simulation accuracy. This study proposed the use of reduced order modeling (ROM) techniques to capture experimentally measured displacement fields of rat vaginal tissue during inflation testing in order to attain both the accuracy of higher‐fidelity models and the speed of simpler simulations. The proper orthogonal decomposition (POD) method was used to extract the significant information from FE simulations generated by varying the luminal pressure and the parameters that introduce the anisotropy in the selected constitutive model. A new data‐driven (DD) variational multiscale (VMS) ROM framework was extended to obtain the displacement fields of rat vaginal tissue under pressure. For comparison purposes, we also investigated the classical Galerkin ROM (G‐ROM). In our numerical study, both the G‐ROM and the DD‐VMS‐ROM decreased the FE computational cost by orders of magnitude without a significant decrease in numerical accuracy. Furthermore, the DD‐VMS‐ROM improved the G‐ROM accuracy at a modest computational overhead. Our numerical investigation showed that ROM has the potential to provide efficient and accurate computational tools to describe vaginal deformations, with the ultimate goal of improving maternal health.