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Modélisation de la cavité pelvienne

Mechanical model of the pelvic cavity: development strategy

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Pelvi-périnéologie

Résumé

Le prolapsus urogénital affecte l’équilibre anatomique et mécanique de la statique pelvienne. Les hypothèses physiopathologiques sont nombreuses. Étant donné la complexité des systèmes biomécaniques en jeu, il est nécessaire de mettre au point et de développer des modèles informatiques. Ils constituent une simplification des systèmes étudiés et permettent de simuler et de prévoir leurs comportements face à des modifications de l’environnement. Le modèle simule des situations physiologiques, pathologiques ou thérapeutiques. Notre objectif est d’aboutir à une évaluation de la maladie et à une personnalisation thérapeutique des troubles de la statique pelvienne. Nous avons défini un premier cahier des charges représenté par les prérequis au développement du modèle pelvien. Cette méthodologie repose sur trois axes principaux et incontournables: l’élaboration d’un modèle géométrique, la caractérisation mécanique des tissus organiques et la réalisation de mesures de contraintes mécaniques in vivo. L’étude préliminaire de faisabilité du modèle de cavité pelvienne a permis initialement de poser les bases du modèle, les moyens à mettre en œuvre tant sur les plans humains que matériels. Le modèle mécanique de cavité pelvienne est en constante évolution. Son développement répond à une politique d’évaluation de nos pratiques. Le modèle sera un outil objectif supplémentaire d’évaluation de la maladie et des techniques de correction. Il permettra le développement d’innovations efficaces et sûres pour diagnostiquer, prendre en charge et traiter le prolapsus. Il est à l’heure actuelle non exploitable à ce titre, mais en devenir. Il reste à envisager les solutions pour lever les verrous technologiques à son développement.

Abstract

Pelvic organ prolapse is caused by the anatomical and mechanical dysfunction of the pelvic floor. Numerous hypotheses attempt to explain the cause of the condition. Because many biomechanical systems are involved, the creation of computer simulation models is necessary. Modelling not only simplifies the systems under study, but also makes it possible to simulate and forecast their behaviour in different environmental contexts. The aim of mechanical models of the pelvic cavity is to simulate physiological, pathological and therapeutic situations. We defined three lines of approach for evaluating a patient’s condition and determining an individualised treatment plan. First, we developed a geometrical model, then determined the mechanics of pelvic organ tissues. As a third step, we identified in vivo mechanical constraints by measuring intravaginal pressure. This mechanical model of the pelvic cavity is in ongoing development, advancing based on our expanding knowledge. The model will be used as a tool to assess the disorder accurately and test new, innovative techniques.

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Authors and Affiliations

  1. Pôle de chirurgie gynécologique et obstétrique, hôpital Jeanne-de-Flandre, centre hospitalier régional universitaire de Lille, 2, avenue Oscar-Lambret, F-59037, Lille, France

    M. Boukerrou, C. Rubod, N. Coutty & M. Cosson

  2. Laboratoire de mécanique de Lille, école centrale de Lille, boulevard Paul-Langevin, cité scientifique, BP 48, F-59651, Villeneuve-d’Ascq, France

    M. Brieu

  3. INSERM U703, Institut de technologie médicale, pavillon Vancostenobel, centre hospitalier régional universitaire de Lille, F-59037, Lille, France

    P. Dubois

Authors
  1. M. Boukerrou
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  2. C. Rubod
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  3. N. Coutty
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  4. M. Brieu
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  5. P. Dubois
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  6. M. Cosson
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Correspondence to M. Boukerrou.

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Boukerrou, M., Rubod, C., Coutty, N. et al. Modélisation de la cavité pelvienne. Pelv Perineol 2, 33–41 (2007). https://doi.org/10.1007/s11608-007-0111-7

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  • DOI: https://doi.org/10.1007/s11608-007-0111-7

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