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Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal 2 S. João Hospital Porto Portugal 3 IDMEC Faculty of Engineering University of Porto Portugal D. d'Aulignac(1), J.A.C. Martins(1), T. Mascarenhas(2), R.M. Natal Jorge(3) and E.B. Pires(1)

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Page 1: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

Modeling the Pelvic Floor using Shell Elements

1Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

2S. João HospitalPortoPortugal

3IDMECFaculty of EngineeringUniversity of Porto Portugal

D. d'Aulignac(1), J.A.C. Martins(1), T. Mascarenhas(2), R.M. Natal Jorge(3) and E.B. Pires(1)

Page 2: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

2

Plan

AnatomyFinite Element

Simulation

Data Geometry

Page 3: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

3

Why? Understand working of the pelvic

floor Support of organs

Predict damages during childbirth Stress incontinence Prolapse

Uterine Vaginal Rectal

Page 4: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

4

Pelvic Floor

Illust. From Netter

Page 5: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

5

MRI Images Sao Joao Hospital, Porto

axial sagittal

Page 6: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

6

Visualisation

Rasmussen et al (University of Illinois at Chicago)

Segmented manually from MRI data. Julia R. Fielding et al. (Harvard medical school)

Page 7: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

7

Cadaver Measurements

Janda et al 2003

Page 8: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

8

Geometry

Point SetNURB

Surfaces(Rhino 3d)

PolygonMesh

Page 9: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

9

Mesh Geometry

top

side

Frontal view of the mesh:

3068 triangles

1620 nodes

Page 10: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

10

3D Muscle Model

1

1[2 ' ' ] '

''

''

''

I f f J

II C

ff

f

JJ

dev U B U n n U IJU

UI

UU

UU

J

isotropic

fibers

volume

Martins et al. 98

Page 11: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

11

Muscle Model

11 12

21 22p

F FF

F F

Tp p pB F F

Tp p pC F F

Deformation gradient

Left Cauchy-Green tensor

Right Cauchy-Green tensor

233 33 33B C F

Page 12: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

12

Muscle Model

1 33( )CpI tr C C

Tf p pN CN

p pp

f

F Nn

Fibre strain

Direction of fibres (deformed)

First Invariant

Page 13: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

13

Plane Stress

33

33

33

1

1

det( )

0

2 ' ( ) '

p

p I p f f p p

J

FF

U B B I U n n

Since incompressibility is assumed

Since normal stresses are zero the plane stress is given as

Page 14: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

14

Passive Behaviour

}1])1({exp[

}1)]3({exp[

)()(

2

1

1

ff

CI

ffC

I

aAU

IbcU

UIUU

Humphrey’s model for

cardiac tissue

isotropic fibres

2

2

3.87 /

23.46

5.84 /

12.43

c g cm

b

A g cm

a

Page 15: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

15

Passive Tests

lambda

)/( 2cmgstress

Page 16: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

16

Muscle Fibres

Page 17: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

17

Active Behaviour

Page 18: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

18

Muscle Activation

( ) ( , )f pas f act fU U U

20

1

1 4( 1)

for 0.5 1.5

Mact f

f

U T

Sum of passive and active contributions

Page 19: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

19

Total Stress

active

total isotropic

fibers

2( / )g cm

Page 20: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

20

Discussion Large quantitative differences between

different models Oomens Martins Bosboom Gielen Kojic Humphrey

Comparison with other models and experimental results is essential

Page 21: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

21

Simulation

3068 triangular shell elements

Non-linear simulation performed with ABAQUS

UMAT routine decribing the material

Page 22: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

22

Muscle Activation

Page 23: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

23

The Future Deformation of pelvic floor during

childbirth Damage, fracture of soft tissues Prolapse of internal organs Geometric models from MRI data 8-node solid FE (de Sousa et al. 03)

Page 24: Modeling the Pelvic Floor using Shell Elements 1 Departamento de Engenharia Civil Instituto Superior Técnico Av. Rovisco Pais 1049-001 Lisboa Portugal

24

Muscle Model

11 12

21 2233

33

00

00

0 0

p

F FF

F F FF

F

233 33

0 0

0 0

TpT p pB F F

B FFB F

233 33

0 0

0 0

TpT p pC F F

C F FC F

Deformation gradient

Left Cauchy-Green tensor

Right Cauchy-Green tensor