{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T14:21:04Z","timestamp":1780928464615,"version":"3.54.1"},"reference-count":43,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T00:00:00Z","timestamp":1780876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"the European Union and the State Budget of the Czech Republic","award":["CZ.02.01.01\/00\/23_021\/0008828"],"award-info":[{"award-number":["CZ.02.01.01\/00\/23_021\/0008828"]}]},{"name":"Charles University Cooperatio Program","award":["MED\/DIAG"],"award-info":[{"award-number":["MED\/DIAG"]}]},{"name":"Cooperatio Program, Maternal and Childhood Care","award":["no.207035"],"award-info":[{"award-number":["no.207035"]}]},{"DOI":"10.13039\/100007397","name":"Charles University in Prague","doi-asserted-by":"crossref","award":["COUGAR network"],"award-info":[{"award-number":["COUGAR network"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100007397","name":"Charles University in Prague","doi-asserted-by":"crossref","award":["UNCE\/24\/MED\/018"],"award-info":[{"award-number":["UNCE\/24\/MED\/018"]}],"id":[{"id":"10.13039\/100007397","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urogynecol J"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and Hypothesis<\/jats:title>\n                    <jats:p>The objective was to assess the regional variability, mechanical properties, and histological composition of the perineal body in postmenopausal ewes with and without delayed estrogen replacement therapy (ERT), providing data relevant for pelvic floor modeling and the understanding of menopausal tissue changes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      The fibromuscular layer of the central tendon of the perineal area between the rectum and vagina was used for the study. We analyzed 24 specimens from 8 postmenopausal ewes with ERT (initiated 180\u00a0days after ovariectomy and continued for 100\u00a0days)\u2014POST-ERT group\u2014and 21 specimens from 7 ewes without ERT\u2014POST group, all 280\u00a0days after ovariectomy. Uniaxial tensile tests determined the Young\u2019s moduli in small (E\n                      <jats:sub>0<\/jats:sub>\n                      ) and large (E\n                      <jats:sub>1<\/jats:sub>\n                      ) deformation regions, ultimate stress, and ultimate strain. Histological stereology quantified volume fractions of collagen, elastin, smooth muscle, skeletal muscle, and adipose tissue in three regions (R1\u2013R3). Group comparisons and regional analyses were performed using nonparametric statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mechanical parameters did not differ significantly between groups (E\n                      <jats:sub>0<\/jats:sub>\n                      : 28\/25\u00a0kPa; E\n                      <jats:sub>1<\/jats:sub>\n                      : 0.38\/0.33\u00a0MPa; ultimate stress: 0.23\/0.23\u00a0MPa; ultimate strain: 0.94\/0.90 for POST-ERT\/POST). ERT was associated with higher collagen (33% versus 23%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and elastin (6% versus 5%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.01) content. Regional differences were minimal, with only modest variation in adipose and smooth-muscle fractions and ultimate stress between the midline and lateral regions.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Despite prolonged estrogen deprivation, the perineal body maintained mechanical integrity. Structural changes, particularly increased collagen and elastin after delayed ERT, suggest adaptive remodeling but do not translate into measurable biomechanical reinforcement within the studied timeframe. The results provide parameters for finite element modeling of pelvic floor disorders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-026-06692-7","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:33:10Z","timestamp":1780925590000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Histological Microstructure and In Vitro Mechanical Properties of Postmenopausal Ewe Perineal Body With and Without Estrogen Replacement Therapy"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7411-3065","authenticated-orcid":false,"given":"Petra","family":"Kochova","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie Hajkova","family":"Hympanova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katerina","family":"Mackova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Cimrman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zbynek","family":"Tonar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Deprest","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Kalis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"6692_CR1","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.bpg.2009.04.008","volume":"23","author":"J Stoker","year":"2009","unstructured":"Stoker J. Anorectal and pelvic floor anatomy. Best Pract Res Clin Gastroenterol. 2009;23:463\u201375. https:\/\/doi.org\/10.1016\/j.bpg.2009.04.008.","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"6692_CR2","volume-title":"Williams gynecology","author":"BL Hoffman","year":"2012","unstructured":"Hoffman BL, Schorge JO, Bradshaw KD, Halvorson LM, Schaffer JI, Corton MM. Williams gynecology. 3rd ed. McGraw-Hill Education; 2012.","edition":"3rd ed"},{"key":"6692_CR3","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s13669-015-0115-1","volume":"4","author":"G Rostaminia","year":"2015","unstructured":"Rostaminia G, Abramowitch S. Finite element modeling in female pelvic floor medicine: a literature review. Curr Obstet Gynecol Rep. 2015;4:125\u201331. https:\/\/doi.org\/10.1007\/s13669-015-0115-1.","journal-title":"Curr Obstet Gynecol Rep"},{"key":"6692_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2015\/845985","volume":"2015","author":"S Ren","year":"2015","unstructured":"Ren S, Xie B, Wang J, Rong Q. Three-dimensional modeling of the pelvic floor support systems of subjects with and without pelvic organ prolapse. Biomed Res Int. 2015;2015:1\u20139. https:\/\/doi.org\/10.1155\/2015\/845985.","journal-title":"Biomed Res Int"},{"key":"6692_CR5","doi-asserted-by":"publisher","first-page":"1060","DOI":"10.1007\/s10439-008-9471-6","volume":"36","author":"KF Noakes","year":"2008","unstructured":"Noakes KF, Bissett IP, Pullan AJ, Cheng LK. Anatomically realistic three-dimensional meshes of the pelvic floor & anal canal for finite element analysis. Ann Biomed Eng. 2008;36:1060\u201371. https:\/\/doi.org\/10.1007\/s10439-008-9471-6.","journal-title":"Ann Biomed Eng"},{"key":"6692_CR6","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1080\/10255840500405378","volume":"8","author":"D D\u2019Aulignac","year":"2005","unstructured":"D\u2019Aulignac D, Martins JAC, Pires EB, Mascarenhas T, Jorge RM. A shell finite element model of the pelvic floor muscles. Comput Methods Biomech Biomed Engin. 2005;8:339\u201347. https:\/\/doi.org\/10.1080\/10255840500405378.","journal-title":"Comput Methods Biomech Biomed Engin"},{"key":"6692_CR7","doi-asserted-by":"publisher","first-page":"1575","DOI":"10.1016\/j.jbiomech.2015.02.056","volume":"48","author":"L Chen","year":"2015","unstructured":"Chen L, Low LK, DeLancey JOL, Ashton-Miller JA. In vivo estimation of perineal body properties using ultrasound quasistatic elastography in nulliparous women. J Biomech. 2015;48:1575\u20139. https:\/\/doi.org\/10.1016\/j.jbiomech.2015.02.056.","journal-title":"J Biomech"},{"key":"6692_CR8","unstructured":"Jing D, Lien K-C, Ashton-Miller JA, DeLancey JOL. Visco-elastic properties of the pelvic floor muscle in healthy women. In: Ashton-Miller JA, Hughes RE, Andrews D, editors. North American Congress of Biomechanics; 2008. pp 562, 1\u20132."},{"key":"6692_CR9","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1097\/GME.0000000000001166","volume":"26","author":"P Kochov\u00e1","year":"2019","unstructured":"Kochov\u00e1 P, Cimrman R, Jansov\u00e1 M, Michalov\u00e1 K, Kalis V, Kub\u00edkov\u00e1 T, et al. The histological microstructure and in vitro mechanical properties of the human female postmenopausal perineal body. Menopause. 2019;26:66\u201377. https:\/\/doi.org\/10.1097\/GME.0000000000001166.","journal-title":"Menopause"},{"key":"6692_CR10","doi-asserted-by":"publisher","first-page":"1289","DOI":"10.1097\/GME.0000000000001395","volume":"26","author":"P Kochov\u00e1","year":"2019","unstructured":"Kochov\u00e1 P, Hymp\u00e1nov\u00e1 L, Rynkevic R, Cimrman R, Tonar Z, Deprest J, et al. The histological microstructure and in vitro mechanical properties of pregnant and postmenopausal ewe perineal body. Menopause. 2019;26:1289\u2013301. https:\/\/doi.org\/10.1097\/GME.0000000000001395.","journal-title":"Menopause"},{"key":"6692_CR11","doi-asserted-by":"publisher","DOI":"10.1097\/SPV.0B013E3181D7E86E","volume":"16","author":"M Krause","year":"2010","unstructured":"Krause M, Wheeler TL, Richter HE, Snyder TE. Systemic effects of vaginally administered estrogen therapy: a review. Female Pelvic Med Reconstr Surg. 2010;16:188. https:\/\/doi.org\/10.1097\/SPV.0B013E3181D7E86E.","journal-title":"Female Pelvic Med Reconstr Surg"},{"key":"6692_CR12","doi-asserted-by":"publisher","DOI":"10.1007\/S00192-019-04070-0","volume":"31","author":"B Bodner-Adler","year":"2019","unstructured":"Bodner-Adler B, Alarab M, Ruiz-Zapata AM, Latthe P. Effectiveness of hormones in postmenopausal pelvic floor dysfunction\u2014International Urogynecological Association research and development\u2014committee opinion. Int Urogynecol J. 2019;31:1577. https:\/\/doi.org\/10.1007\/S00192-019-04070-0.","journal-title":"Int Urogynecol J"},{"issue":"Suppl","key":"6692_CR13","doi-asserted-by":"publisher","first-page":"S146","DOI":"10.1016\/j.ejogrb.2009.02.022","volume":"144","author":"SD Abramowitch","year":"2009","unstructured":"Abramowitch SD, Feola A, Jallah Z, Moalli P. Tissue mechanics, animal models, and pelvic organ prolapse: a review. Eur J Obstet Gynecol Reprod Biol. 2009;144(Suppl):S146-58. https:\/\/doi.org\/10.1016\/j.ejogrb.2009.02.022.","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"6692_CR14","doi-asserted-by":"publisher","DOI":"10.1115\/1.4034442","volume":"68","author":"A Baah-Dwomoh","year":"2016","unstructured":"Baah-Dwomoh A, McGuire J, Tan T, De Vita R. Mechanical properties of female reproductive organs and supporting connective tissues: a review of the current state of knowledge. Appl Mech Rev. 2016;68:060801. https:\/\/doi.org\/10.1115\/1.4034442.","journal-title":"Appl Mech Rev"},{"key":"6692_CR15","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1007\/S00192-020-04638-1","volume":"32","author":"MGMC Mori da Cunha","year":"2021","unstructured":"Mori da Cunha MGMC, Mackova K, Hympanova LH, Bortolini MAT, Deprest J. Animal models for pelvic organ prolapse: systematic review. Int Urogynecol J. 2021;32:1331\u201344. https:\/\/doi.org\/10.1007\/S00192-020-04638-1.","journal-title":"Int Urogynecol J"},{"key":"6692_CR16","doi-asserted-by":"publisher","first-page":"797","DOI":"10.1007\/S00192-022-05387-Z\/TABLES\/2","volume":"34","author":"F Fang","year":"2023","unstructured":"Fang F, Zhao Z, Xiao J, Wen J, Wu J, Miao Y. Current practice in animal models for pelvic floor dysfunction. Int Urogynecol J. 2023;34:797\u2013808. https:\/\/doi.org\/10.1007\/S00192-022-05387-Z\/TABLES\/2.","journal-title":"Int Urogynecol J"},{"key":"6692_CR17","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1159\/000454771","volume":"82","author":"I Urbankova","year":"2017","unstructured":"Urbankova I, Vdoviakova K, Rynkevic R, Sindhwani N, Deprest D, Feola A, et al. Comparative anatomy of the ovine and female pelvis. Gynecol Obstet Invest. 2017;82:582\u201391. https:\/\/doi.org\/10.1159\/000454771.","journal-title":"Gynecol Obstet Invest"},{"key":"6692_CR18","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/S0378-4320(96)01629-6","volume":"47","author":"NR Adams","year":"1997","unstructured":"Adams NR, Briegel JR, Sanders MR, Blackberry MA, Martin GB. Level of nutrition modulates the dynamics of oestradiol feedback on plasma FSH in ovariectomized ewes. Anim Reprod Sci. 1997;47:59\u201370. https:\/\/doi.org\/10.1016\/S0378-4320(96)01629-6.","journal-title":"Anim Reprod Sci"},{"key":"6692_CR19","doi-asserted-by":"publisher","first-page":"404","DOI":"10.1095\/BIOLREPROD23.2.404","volume":"23","author":"FJ Karsch","year":"1980","unstructured":"Karsch FJ, Legan SJ, Ryan KD, Foster DL. Importance of estradiol and progesterone in regulating LH secretion and estrous behavior during the sheep estrous cycle. Biol Reprod. 1980;23:404\u201313. https:\/\/doi.org\/10.1095\/BIOLREPROD23.2.404.","journal-title":"Biol Reprod"},{"key":"6692_CR20","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1111\/1471-0528.16558","volume":"128","author":"K Mackova","year":"2021","unstructured":"Mackova K, Mazzer AM, Mori Da Cunha MGMC, Hajkova Hympanova L, Urbankova I, Kastelein AW, et al. Vaginal Er:YAG laser application in the menopausal ewe model: a randomised estrogen and sham-controlled trial. BJOG. 2021;128:1087\u201396. https:\/\/doi.org\/10.1111\/1471-0528.16558.","journal-title":"BJOG"},{"key":"6692_CR21","volume-title":"Unbiased stereology: three-dimensional measurement in microscopy (advanced methods)","author":"V Howard","year":"2005","unstructured":"Howard V, Reed M. Unbiased stereology: three-dimensional measurement in microscopy (advanced methods). 2nd ed. New York: Garland Science; 2005.","edition":"2nd ed"},{"key":"6692_CR22","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1111\/J.1365-2818.1986.TB04282.X","volume":"142","author":"AJ Baddeley","year":"1986","unstructured":"Baddeley AJ, Gundersen HJG, Cruz-Orive LM. Estimation of surface area from vertical sections. J Microsc. 1986;142:259\u201376. https:\/\/doi.org\/10.1111\/J.1365-2818.1986.TB04282.X.","journal-title":"J Microsc"},{"key":"6692_CR23","volume-title":"Histological and histochemical methods: theory and practice","author":"J Kiernan","year":"2008","unstructured":"Kiernan J. Histological and histochemical methods: theory and practice. 4th ed. Banbury: Scion Publishing; 2008.","edition":"4th ed"},{"key":"6692_CR24","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1111\/AHE.12765","volume":"51","author":"Y Kolinko","year":"2022","unstructured":"Kolinko Y, Male\u010dkov\u00e1 A, Kochov\u00e1 P, Grajciarov\u00e1 M, Blassov\u00e1 T, Kural T, et al. Using virtual microscopy for the development of sampling strategies in quantitative histology and design-based stereology. Anat Histol Embryol. 2022;51:3\u201322. https:\/\/doi.org\/10.1111\/AHE.12765.","journal-title":"Anat Histol Embryol"},{"key":"6692_CR25","volume-title":"Principles and practices of unbiased stereology: an introduction for bioscientists","author":"PR Mouton","year":"2001","unstructured":"Mouton PR. Principles and practices of unbiased stereology: an introduction for bioscientists. Baltimore: Johns Hopkins University Press; 2001."},{"key":"6692_CR26","unstructured":"Lenhard W, Lenhard A. Computation of different effect sizes like d, f, r and transformation of different effect sizes: psychometrica. https:\/\/www.psychometrica.de\/effect_size.html. Accessed 8 April 2025."},{"key":"6692_CR27","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/J.THERIOGENOLOGY.2021.09.006","volume":"176","author":"MA Vasquez-Hidalgo","year":"2021","unstructured":"Vasquez-Hidalgo MA, Kelany K, Grazul-Bilska AT, Bauer M, Swanson KC, Perry GA, et al. Acute effects of estradiol-17\u03b2 on plasma volume and uterine cell proliferation in sheep. Theriogenology. 2021;176:12\u20137. https:\/\/doi.org\/10.1016\/J.THERIOGENOLOGY.2021.09.006.","journal-title":"Theriogenology"},{"key":"6692_CR28","doi-asserted-by":"publisher","DOI":"10.3389\/FMATS.2021.793647\/FULL","volume":"8","author":"M Sharabi","year":"2022","unstructured":"Sharabi M. Structural mechanisms in soft fibrous tissues: a review. Front Mater. 2022;8:793647. https:\/\/doi.org\/10.3389\/FMATS.2021.793647\/FULL.","journal-title":"Front Mater"},{"issue":"3","key":"6692_CR29","doi-asserted-by":"publisher","DOI":"10.3390\/BIOM13030574","volume":"13","author":"H Tr\u0119bacz","year":"2023","unstructured":"Tr\u0119bacz H, Barzycka A. Mechanical properties and functions of elastin: an overview. Biomolecules. 2023;13(3):574. https:\/\/doi.org\/10.3390\/BIOM13030574.","journal-title":"Biomolecules"},{"key":"6692_CR30","doi-asserted-by":"publisher","DOI":"10.1016\/J.JBIOMECH.2011.11.016","volume":"45","author":"MR Hill","year":"2012","unstructured":"Hill MR, Duan X, Gibson GA, Watkins S, Robertson AM. A theoretical and non-destructive experimental approach for direct inclusion of measured collagen orientation and recruitment into mechanical models of the artery wall. J Biomech. 2012;45:762. https:\/\/doi.org\/10.1016\/J.JBIOMECH.2011.11.016.","journal-title":"J Biomech"},{"key":"6692_CR31","doi-asserted-by":"publisher","first-page":"15","DOI":"10.1007\/S00192-021-04953-1","volume":"33","author":"LGO Brito","year":"2022","unstructured":"Brito LGO, Pereira GMV, Moalli P, Shynlova O, Manonai J, Weintraub AY, et al. Age and\/or postmenopausal status as risk factors for pelvic organ prolapse development: systematic review with meta-analysis. Int Urogynecol J. 2022;33:15\u201329. https:\/\/doi.org\/10.1007\/S00192-021-04953-1.","journal-title":"Int Urogynecol J"},{"key":"6692_CR32","doi-asserted-by":"publisher","DOI":"10.1038\/srep45709","volume":"7","author":"S Emmerson","year":"2017","unstructured":"Emmerson S, Young N, Rosamilia A, Parkinson L, Edwards SL, Vashi AV, et al. Ovine multiparity is associated with diminished vaginal muscularis, increased elastic fibres and vaginal wall weakness: implication for pelvic organ prolapse. Sci Rep. 2017;7:45709. https:\/\/doi.org\/10.1038\/srep45709.","journal-title":"Sci Rep"},{"key":"6692_CR33","doi-asserted-by":"publisher","DOI":"10.3389\/FMED.2024.1342645","volume":"11","author":"M Yang","year":"2024","unstructured":"Yang M, Chen C, Wang Z, Long J, Huang R, Qi W, et al. Finite element analysis of female pelvic organ prolapse mechanism: current landscape and future opportunities. Front Med (Lausanne). 2024;11:1342645. https:\/\/doi.org\/10.3389\/FMED.2024.1342645.","journal-title":"Front Med (Lausanne)"},{"key":"6692_CR34","doi-asserted-by":"publisher","DOI":"10.3389\/FMED.2022.820016","volume":"9","author":"X Liu","year":"2022","unstructured":"Liu X, Rong Q, Liu Y, Wang J, Xie B, Ren S. Relationship between high intra-abdominal pressure and compliance of the pelvic floor support system in women without pelvic organ prolapse: a finite element analysis. Front Med (Lausanne). 2022;9:820016. https:\/\/doi.org\/10.3389\/FMED.2022.820016.","journal-title":"Front Med (Lausanne)"},{"key":"6692_CR35","doi-asserted-by":"publisher","first-page":"1425","DOI":"10.1007\/S10237-023-01729-Y","volume":"22","author":"X Xue","year":"2023","unstructured":"Xue X, Wang H, Xie J, Gao Z, Shen J, Yao T. Two-dimensional biomechanical finite element modeling of the pelvic floor and prolapse. Biomech Model Mechanobiol. 2023;22:1425\u201346. https:\/\/doi.org\/10.1007\/S10237-023-01729-Y.","journal-title":"Biomech Model Mechanobiol"},{"key":"6692_CR36","doi-asserted-by":"publisher","DOI":"10.1098\/RSFS.2019.0022","volume":"9","author":"MT Gordon","year":"2019","unstructured":"Gordon MT, DeLancey JOL, Renfroe A, Battles A, Chen L. Development of anatomically based customizable three-dimensional finite-element model of pelvic floor support system: POP-SIM1.0. Interface Focus. 2019;9:20190022. https:\/\/doi.org\/10.1098\/RSFS.2019.0022.","journal-title":"Interface Focus"},{"key":"6692_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S13244-019-0687-9\/FIGURES\/23","volume":"10","author":"JC Salvador","year":"2019","unstructured":"Salvador JC, Coutinho MP, Ven\u00e2ncio JM, Viamonte B. Dynamic magnetic resonance imaging of the female pelvic floor\u2014a pictorial review. Insights Imaging. 2019;10:1\u201316. https:\/\/doi.org\/10.1186\/S13244-019-0687-9\/FIGURES\/23.","journal-title":"Insights Imaging"},{"key":"6692_CR38","doi-asserted-by":"publisher","DOI":"10.3390\/LIFE11121397","volume":"11","author":"S Tim","year":"2021","unstructured":"Tim S, Mazur-Bialy AI. The most common functional disorders and factors affecting female pelvic floor. Life. 2021;11:1397. https:\/\/doi.org\/10.3390\/LIFE11121397.","journal-title":"Life"},{"key":"6692_CR39","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1002\/ca.10034","volume":"15","author":"PJ Woodman","year":"2002","unstructured":"Woodman PJ, Graney DO. Anatomy and physiology of the female perineal body with relevance to obstetrical injury and repair. Clin Anat. 2002;15:321\u201334. https:\/\/doi.org\/10.1002\/ca.10034.","journal-title":"Clin Anat"},{"key":"6692_CR40","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/S00192-014-2554-Z","volume":"26","author":"DD Rahn","year":"2015","unstructured":"Rahn DD, Ward RM, Sanses TV, Carberry C, Mamik MM, Meriwether KV, et al. Vaginal estrogen use in postmenopausal women with pelvic floor disorders: systematic review and practice guidelines. Int Urogynecol J. 2015;26:3\u201313. https:\/\/doi.org\/10.1007\/S00192-014-2554-Z.","journal-title":"Int Urogynecol J"},{"key":"6692_CR41","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD014592.PUB2","volume":"2023","author":"A Taithongchai","year":"2023","unstructured":"Taithongchai A, Johnson EE, Ismail SI, Barron-Millar E, Kernohan A, Thakar R. Oestrogen therapy for treating pelvic organ prolapse in postmenopausal women. Cochrane Database Syst Rev. 2023;2023:CD014592. https:\/\/doi.org\/10.1002\/14651858.CD014592.PUB2.","journal-title":"Cochrane Database Syst Rev"},{"key":"6692_CR42","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1056\/NEJMOA1505241","volume":"374","author":"HN Hodis","year":"2016","unstructured":"Hodis HN, Mack WJ, Henderson VW, Budoff MJ, Hwang-Levine J, Li Y, et al. Vascular effects of early versus late postmenopausal treatment with estradiol. N Engl J Med. 2016;374:1221\u201331. https:\/\/doi.org\/10.1056\/NEJMOA1505241.","journal-title":"N Engl J Med"},{"key":"6692_CR43","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2026.108858","volume":"207","author":"SP Gonz\u00e1lez","year":"2026","unstructured":"Gonz\u00e1lez SP, Nieto-Pascual L, L\u00f3pez-Freire D, Palacios S. The window of opportunity for treating vulvovaginal atrophy in menopause: insights from oestrogen receptor distribution and age-related changes. Maturitas. 2026;207:108858. https:\/\/doi.org\/10.1016\/j.maturitas.2026.108858.","journal-title":"Maturitas"}],"container-title":["International Urogynecology Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06692-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00192-026-06692-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00192-026-06692-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T13:33:14Z","timestamp":1780925594000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00192-026-06692-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,8]]},"references-count":43,"alternative-id":["6692"],"URL":"https:\/\/doi.org\/10.1007\/s00192-026-06692-7","relation":{},"ISSN":["0937-3462","1433-3023"],"issn-type":[{"value":"0937-3462","type":"print"},{"value":"1433-3023","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,8]]},"assertion":[{"value":"8 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 April 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 June 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":"This animal experiment was approved by the Animal Ethics Committee of the KU Leuven (registration number: P038\/2018) in accordance with the Animals (Scientific Procedures) Act 1986 and performed in compliance with the EU regulations as declared in Directive 2010\/63\/EU and approved by the local IRB.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical\/Institutional Review Board Approval"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of Interest"}}]}}