{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T22:45:58Z","timestamp":1792795558177,"version":"4.5.0"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/100019214","name":"l\u00e9ka\u0159sk\u00e1 fakulta Univerzity Karlovy","doi-asserted-by":"publisher","award":["207 035"],"award-info":[{"award-number":["207 035"]}],"id":[{"id":"10.13039\/100019214","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"crossref","award":["CZ.02.01.01\/00\/23_021\/0008828"],"award-info":[{"award-number":["CZ.02.01.01\/00\/23_021\/0008828"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100009553","name":"Agentura Pro Zdravotnick\u00fd V\u00fdzkum \u010cesk\u00e9 Republiky","doi-asserted-by":"publisher","award":["NW26J-08-00143"],"award-info":[{"award-number":["NW26J-08-00143"]}],"id":[{"id":"10.13039\/501100009553","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"published-print":{"date-parts":[[2026,6]]},"DOI":"10.1007\/s00192-026-06565-z","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T13:11:33Z","timestamp":1773148293000},"page":"1763-1771","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Biomechanical Model of the Levator Ani Muscle: Identifying the Greatest Strain Areas in Its Subdivisions"],"prefix":"10.1007","volume":"37","author":[{"given":"Jan","family":"Zapletal","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hana","family":"Cechova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Jansova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Cimrman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ludek","family":"Hyncik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ladislav","family":"Krofta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helena","family":"Robova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9002-9231","authenticated-orcid":false,"given":"Lucie","family":"Hajkova Hympanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"6565_CR1","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s00192-021-05018-z","volume":"33","author":"HW Brown","year":"2022","unstructured":"Brown HW, Hegde A, Huebner M, et al. International urogynecology consultation chapter 1 committee 2: epidemiology of pelvic organ prolapse: prevalence, incidence, natural history, and service needs. Int Urogynecol J. 2022;33:173\u201387. https:\/\/doi.org\/10.1007\/s00192-021-05018-z.","journal-title":"Int Urogynecol J"},{"key":"6565_CR2","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1097\/AOG.0000000000000286","volume":"123","author":"JM Wu","year":"2014","unstructured":"Wu JM, Matthews CA, Conover MM, et al. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet Gynecol. 2014;123:1201\u20136. https:\/\/doi.org\/10.1097\/AOG.0000000000000286.","journal-title":"Obstet Gynecol"},{"key":"6565_CR3","doi-asserted-by":"publisher","first-page":"1783","DOI":"10.1007\/s00192-013-2169-9","volume":"24","author":"MD Barber","year":"2013","unstructured":"Barber MD, Maher C. Epidemiology and outcome assessment of pelvic organ prolapse. Int Urogynecol J. 2013;24:1783\u201390. https:\/\/doi.org\/10.1007\/s00192-013-2169-9","journal-title":"Int Urogynecol J"},{"key":"6565_CR4","doi-asserted-by":"publisher","first-page":"1971","DOI":"10.1007\/s00192-023-05533-1","volume":"34","author":"L Horcicka","year":"2023","unstructured":"Horcicka L, Krcmar M, Nemec M, et al. Appearance of levator ani muscle subdivision defects on level III vaginal support structures in women with and without pelvic organ prolapse: an MRI study. Int Urogynecol J. 2023;34:1971\u201382. https:\/\/doi.org\/10.1007\/s00192-023-05533-1.","journal-title":"Int Urogynecol J"},{"key":"6565_CR5","doi-asserted-by":"publisher","first-page":"163","DOI":"10.1146\/annurev-bioeng-061008-124823","volume":"11","author":"JA Ashton-Miller","year":"2009","unstructured":"Ashton-Miller JA, DeLancey JOL. On the biomechanics of vaginal birth and common sequelae. Annu Rev Biomed Eng. 2009;11:163\u201376. https:\/\/doi.org\/10.1146\/annurev-bioeng-061008-124823","journal-title":"Annu Rev Biomed Eng"},{"key":"6565_CR6","doi-asserted-by":"publisher","first-page":"774","DOI":"10.1002\/nau.22649","volume":"34","author":"J Kim","year":"2015","unstructured":"Kim J, Betschart C, Ramanah R, et al. <article-title update=\"added\">Anatomy of the pubovisceral muscle origin: macroscopic and microscopic findings within the injury zone: anatomy of the Pubovisceral Muscle Origin. Neurourol Urodyn. 2015;34:774\u201380. https:\/\/doi.org\/10.1002\/nau.22649.","journal-title":"Neurourol Urodyn"},{"key":"6565_CR7","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1016\/j.ajog.2006.06.062","volume":"195","author":"AC Weidner","year":"2006","unstructured":"Weidner AC, Jamison MG, Branham V, et al. Neuropathic injury to the levator ani occurs in 1 in 4 primiparous women. Am J Obstet Gynecol. 2006;195:1851\u20136. https:\/\/doi.org\/10.1016\/j.ajog.2006.06.062.","journal-title":"Am J Obstet Gynecol"},{"key":"6565_CR8","doi-asserted-by":"publisher","first-page":"96","DOI":"10.1016\/j.ijgo.2006.04.039","volume":"94","author":"E Conner","year":"2006","unstructured":"Conner E, Margulies R, Liu M, et al. Vaginal delivery and serum markers of ischemia\/reperfusion injury. Int J Gynaecol Obstet. 2006;94:96\u2013102. https:\/\/doi.org\/10.1016\/j.ijgo.2006.04.039.","journal-title":"Int J Gynaecol Obstet"},{"key":"6565_CR9","first-page":"46","volume":"101","author":"JOL DeLancey","year":"2003","unstructured":"DeLancey JOL, Kearney R, Chou Q, et al. The appearance of levator ani muscle abnormalities in magnetic resonance images after vaginal delivery. Obstet Gynecol. 2003;101:46\u201353.","journal-title":"Obstet Gynecol"},{"key":"6565_CR10","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1097\/01.aog.0000178779.62181.01","volume":"106","author":"HP Dietz","year":"2005","unstructured":"Dietz HP, Lanzarone V. Levator trauma after vaginal delivery. Obstet Gynecol. 2005;106:707\u201312. https:\/\/doi.org\/10.1097\/01.aog.0000178779.62181.01.","journal-title":"Obstet Gynecol"},{"key":"6565_CR11","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1097\/01.AOG.0000109207.22354.65","volume":"103","author":"K-C Lien","year":"2004","unstructured":"Lien K-C, Mooney B, DeLancey JOL, Ashton-Miller JA. Levator ani muscle stretch induced by simulated vaginal birth. Obstet Gynecol. 2004;103:31\u201340. https:\/\/doi.org\/10.1097\/01.AOG.0000109207.22354.65","journal-title":"Obstet Gynecol"},{"key":"6565_CR12","doi-asserted-by":"publisher","first-page":"1657","DOI":"10.1111\/j.1471-0528.2009.02321.x","volume":"116","author":"K Svab\u00edk","year":"2009","unstructured":"Svab\u00edk K, Shek KL, Dietz HP. How much does the levator hiatus have to stretch during childbirth? BJOG. 2009;116:1657\u201362. https:\/\/doi.org\/10.1111\/j.1471-0528.2009.02321.x","journal-title":"BJOG"},{"issue":"2","key":"6565_CR13","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1113\/jphysiol.1995.sp020980","volume":"488","author":"SV Brooks","year":"1995","unstructured":"Brooks SV, Zerba E, Faulkner JA. Injury to muscle fibres after single stretches of passive and maximally stimulated muscles in mice. J Physiol. 1995;488(2):459\u201369. https:\/\/doi.org\/10.1113\/jphysiol.1995.sp020980.","journal-title":"J Physiol"},{"key":"6565_CR14","doi-asserted-by":"publisher","first-page":"937","DOI":"10.1007\/s10237-022-01569-2","volume":"21","author":"R Moura","year":"2022","unstructured":"Moura R, Borges M, Oliveira D, et al. A biomechanical study of the birth position: a natural struggle between mother and fetus. Biomech Model Mechanobiol. 2022;21:937\u201351. https:\/\/doi.org\/10.1007\/s10237-022-01569-2.","journal-title":"Biomech Model Mechanobiol"},{"key":"6565_CR15","doi-asserted-by":"publisher","first-page":"1315","DOI":"10.1007\/s00192-019-03997-8","volume":"31","author":"L Havelkov\u00e1","year":"2020","unstructured":"Havelkov\u00e1 L, Krofta L, Kochov\u00e1 P, et al. Persistent occiput posterior position and stress distribution in levator ani muscle during vaginal delivery computed by a finite element model. Int Urogynecol J. 2020;31:1315\u201324. https:\/\/doi.org\/10.1007\/s00192-019-03997-8","journal-title":"Int Urogynecol J"},{"key":"6565_CR16","doi-asserted-by":"publisher","DOI":"10.1098\/rsfs.2019.0011","volume":"9","author":"MR Routzong","year":"2019","unstructured":"Routzong MR, Moalli PA, Maiti S, et al. Novel simulations to determine the impact of superficial perineal structures on vaginal delivery. Interface Focus. 2019;9:20190011. https:\/\/doi.org\/10.1098\/rsfs.2019.0011.","journal-title":"Interface Focus"},{"key":"6565_CR17","doi-asserted-by":"publisher","first-page":"1997","DOI":"10.1007\/s00192-021-04769-z","volume":"32","author":"H Cechova","year":"2021","unstructured":"Cechova H, Kalis V, Havelkova L, et al. Finite element modeling of maximum stress in pelvic floor structures during the head expulsion (FINESSE) study. Int Urogynecol J. 2021;32:1997\u20132003. https:\/\/doi.org\/10.1007\/s00192-021-04769-z.","journal-title":"Int Urogynecol J"},{"key":"6565_CR18","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmpb.2023.107874","volume":"243","author":"R Moura","year":"2024","unstructured":"Moura R, Oliveira DA, Parente MPL, et al. A biomechanical perspective on perineal injuries during childbirth. Comput Methods Programs Biomed. 2024;243:107874. https:\/\/doi.org\/10.1016\/j.cmpb.2023.107874.","journal-title":"Comput Methods Programs Biomed"},{"key":"6565_CR19","unstructured":"Gray H. Gray\u2019s Anatomy: with original illustrations by Henry Carter, 2015th ed. Arcturus Publishing Ltd., London, England."},{"key":"6565_CR20","unstructured":"Virtual Performance Solution. 2023.0 | myESI. https:\/\/myesi.esi-group.com\/downloads\/software-downloads\/virtual-performance-solution-2023.0 Accessed 1 Nov 2025."},{"key":"6565_CR21","doi-asserted-by":"publisher","DOI":"10.1115\/1.4055108","volume":"145","author":"S Chen","year":"2023","unstructured":"Chen S, Routzong MR, Abramowitch SD, Grimm MJ. A computational procedure to derive the curve of Carus for childbirth computational modeling. J Biomech Eng. 2023;145:011002. https:\/\/doi.org\/10.1115\/1.4055108","journal-title":"J Biomech Eng"},{"key":"6565_CR22","doi-asserted-by":"publisher","DOI":"10.1016\/j.advengsoft.2021.103033","volume":"159","author":"R Cimrman","year":"2021","unstructured":"Cimrman R. Fast evaluation of finite element weak forms using python tensor contraction packages. Adv Eng Softw. 2021;159:103033. https:\/\/doi.org\/10.1016\/j.advengsoft.2021.103033","journal-title":"Adv Eng Softw"},{"key":"6565_CR23","doi-asserted-by":"publisher","first-page":"1263","DOI":"10.1007\/s00192-014-2395-9","volume":"25","author":"C Betschart","year":"2014","unstructured":"Betschart C, Kim J, Miller JM, et al. Comparison of muscle fiber directions between different levator ani muscle subdivisions: in vivo MRI measurements in women. Int Urogynecol J. 2014;25:1263\u20138. https:\/\/doi.org\/10.1007\/s00192-014-2395-9.","journal-title":"Int Urogynecol J"},{"key":"6565_CR24","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1007\/s00192-016-3126-1","volume":"28","author":"L Krofta","year":"2017","unstructured":"Krofta L, Havelkov\u00e1 L, Urb\u00e1nkov\u00e1 I, et al. Finite element model focused on stress distribution in the levator ani muscle during vaginal delivery. Int Urogynecol J. 2017;28:275\u201384. https:\/\/doi.org\/10.1007\/s00192-016-3126-1.","journal-title":"Int Urogynecol J"},{"key":"6565_CR25","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1111\/j.1600-0412.2011.01315.x","volume":"91","author":"HP Dietz","year":"2012","unstructured":"Dietz HP, Franco AVM, Shek KL, Kirby A. Avulsion injury and levator hiatal ballooning: two independent risk factors for prolapse? An observational study. Acta Obstet Gynecol Scand. 2012;91:211\u20134. https:\/\/doi.org\/10.1111\/j.1600-0412.2011.01315.x","journal-title":"Acta Obstet Gynecol Scand"},{"key":"6565_CR26","doi-asserted-by":"publisher","DOI":"10.1186\/s12884-025-07198-8","volume":"25","author":"X Lin","year":"2025","unstructured":"Lin X, Chen J, Pan H, et al. Comparative magnetic resonance imaging-based study of pelvic floor morphology and function before pregnancy and after primigravida vaginal delivery. BMC Pregnancy Childbirth. 2025;25:62. https:\/\/doi.org\/10.1186\/s12884-025-07198-8.","journal-title":"BMC Pregnancy Childbirth"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06565-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-026-06565-z","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06565-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T12:05:28Z","timestamp":1782475528000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-026-06565-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,10]]},"references-count":26,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["6565"],"URL":"https:\/\/doi.org\/10.1007\/s00192-026-06565-z","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,10]]},"assertion":[{"value":"18 November 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 February 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Study was approved by local ethics committee and institutional review board (IRB) (UPMD_ 6_1_2025). The study was conducted in accordance with the ethical principles outlined in the World Medical Association\u2019s Declaration of Helsinki. Participants provided written informed consent and were informed of their right to withdraw from the study at any time without any consequences.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"EUGA 2024, Prague, 5\u20137.12.2024","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Previous Presentation of this Work"}},{"value":"None.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}}]}}