{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:04:16Z","timestamp":1769213056551,"version":"3.49.0"},"reference-count":25,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,11,29]],"date-time":"2018-11-29T00:00:00Z","timestamp":1543449600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>To evaluate the role of soft tissue and ligaments damage and level of pelvic muscles activation versus intra\u2010abdominal pressure, on pelvic organ prolapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a computational modeling based on the finite element analysis. Three pelvic muscles, four pelvic ligaments, and three organs (urethra, vagina, and rectum) were simulated. The model was subjected to total 41\u2009472 analysis cases including three intra\u2010abdominal pressures, two damaging levels for the ligaments, three damaging levels for the muscles, and four intentional levels of activation for muscles.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Increased intra\u2010abdominal pressures caused significant statistical increase of the pelvic organ prolapse (<jats:italic>P<\/jats:italic>\u2009=\u20090.000) up to 10\u2009mm downward. Ligaments\u2019 defect had no statistically\u2010significant effect on prolapse of the organs (<jats:italic>P<\/jats:italic>\u2009=\u20090.981 for rectum, <jats:italic>P<\/jats:italic>\u2009=\u20090.423 for urethra, and <jats:italic>P<\/jats:italic>\u2009=\u20090.752 for vagina). Damage in the pelvic floor muscles and low intentional level of activation also deteriorated the prolapse (<jats:italic>P<\/jats:italic>\u2009=\u20090.000).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Increase of the intra\u2010abdominal pressure (IAP) as may be existed during pregnancy or physical activity increased the organ prolapse. Damages of the ligaments caused less effects on the prolapse. Loss of the passive properties of the muscles which is probable after delivery or aging moderately deteriorated the prolapse disorder. However, activation of the pelvic floor muscles prevented the prolapse. Different recruitments of the muscles, specifically the pubococcygeus (PCM), could compensate the possible defects in other tissues. Targeted pelvic floor muscle training (PFMT) could also be effective in older adults due to considerable role of the pelvic muscles\u2019 intentional activation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.23885","type":"journal-article","created":{"date-parts":[[2018,11,30]],"date-time":"2018-11-30T05:57:56Z","timestamp":1543557476000},"page":"591-598","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Three\u2010dimensional finite element analysis of the pelvic organ prolapse: A parametric biomechanical modeling"],"prefix":"10.1002","volume":"38","author":[{"given":"Masumeh","family":"Babayi","sequence":"first","affiliation":[{"name":"Department of Biomechanics Faculty of Biomedical Engineering Sahand University of Technology Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9380-2675","authenticated-orcid":false,"given":"Mahmood\u2010Reza","family":"Azghani","sequence":"additional","affiliation":[{"name":"Department of Biomechanics Faculty of Biomedical Engineering Sahand University of Technology Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sakineh","family":"Hajebrahimi","sequence":"additional","affiliation":[{"name":"Research Center for Evidence\u2010Based Medicine Urology department Tabriz University of Medical Sciences Tabriz Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bary","family":"Berghmans","sequence":"additional","affiliation":[{"name":"School for Public Health and Primary Care Maastricht University Maastricht The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,11,29]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181660c1b"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.20144"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13669-015-0115-1"},{"key":"e_1_2_6_5_1","first-page":"59","article-title":"The frequency of pelvic floor dysfunctions and their risk factors in women aged 40\u201355","volume":"6","author":"Eftekhar T","year":"2012","journal-title":"J Fam Reprod Heal"},{"key":"e_1_2_6_6_1","first-page":"31","article-title":"An integral theory of female urinary incontinence","volume":"69","author":"Papa Petros PE","year":"1990","journal-title":"Acta Obstet Gynecol Scand"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/10255842.2016.1186662"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/11566465_45"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2008.04.027"},{"key":"e_1_2_6_10_1","unstructured":"Chanda A Unnikrishnan V Richter HE Lockhart ME. 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