{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T17:59:09Z","timestamp":1793642349781,"version":"4.5.1"},"reference-count":89,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"DOI":"10.1038\/s41598-025-11094-8","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T06:37:05Z","timestamp":1753425425000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Vaginal biomechanical function in premenopausal and postmenopausal women with and without pelvic organ prolapse"],"prefix":"10.1038","volume":"15","author":[{"given":"Qinhan","family":"Zhou","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine X.","family":"Kiley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benard","family":"Ogola","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvis K.","family":"Danso","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyndsey Buckner","family":"Baiamonte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laurephile","family":"Desrosiers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leise R.","family":"Knoepp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah H.","family":"Lindsey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Florian-Rodriguez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. Quincy","family":"Brown","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin S.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"11094_CR1","doi-asserted-by":"publisher","first-page":"975829","DOI":"10.3389\/fpubh.2022.975829","volume":"10","author":"B Wang","year":"2022","unstructured":"Wang, B. et al. Global burden and trends of pelvic organ prolapse associated with aging women: An observational trend study from 1990 to 2019. Front. Public Health 10, 975829 (2022).","journal-title":"Front. Public. Health"},{"key":"11094_CR2","doi-asserted-by":"publisher","first-page":"1201","DOI":"10.1097\/AOG.0000000000000286","volume":"123","author":"JM Wu","year":"2014","unstructured":"Wu, J. M., Matthews, C. A., Conover, M. M., Pate, V. & Funk, M. J. Lifetime risk of stress urinary incontinence or pelvic organ prolapse surgery. Obstet. Gynecol. 123, 1201\u20131206 (2014).","journal-title":"Obstet. Gynecol."},{"key":"11094_CR3","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1097\/MOU.0b013e3283619ed0","volume":"23","author":"D Chow","year":"2013","unstructured":"Chow, D. & Rodr\u00edguez, L. V. Epidemiology and prevalence of pelvic organ prolapse. Curr. Opin. Urol. 23, 293\u2013298 (2013).","journal-title":"Curr. Opin. Urol."},{"key":"11094_CR4","doi-asserted-by":"publisher","first-page":"1160","DOI":"10.1067\/mob.2002.123819","volume":"186","author":"SL Hendrix","year":"2002","unstructured":"Hendrix, S. L. et al. Pelvic organ prolapse in the women\u2019s health initiative: gravity and gravidity. Am. J. Obstet. Gynecol. 186, 1160\u20131166 (2002).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"11094_CR5","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/S0029-7844(97)00218-4","volume":"90","author":"K Strohbehn","year":"1997","unstructured":"Strohbehn, K., Jakary, J. A. & Delancey, J. O. Pelvic organ prolapse in young women. Obstet. Gynecol. 90, 33\u201336 (1997).","journal-title":"Obstet. Gynecol."},{"key":"11094_CR6","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1097\/01.grf.0000170428.45819.4e","volume":"48","author":"JI Schaffer","year":"2005","unstructured":"Schaffer, J. I., Wai, C. Y. & Boreham, M. K. Etiology of pelvic organ prolapse. Clin. Obstet. Gynecol. 48, 639\u2013647 (2005).","journal-title":"Clin. Obstet. Gynecol."},{"key":"11094_CR7","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1007\/s001920200019","volume":"13","author":"J Goh","year":"2002","unstructured":"Goh, J. Biomechanical properties of prolapsed vaginal tissue in pre-and postmenopausal women. Int. Urogynecol. J. 13, 76\u201379 (2002).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR8","doi-asserted-by":"publisher","first-page":"603","DOI":"10.1007\/s00192-006-0214-7","volume":"18","author":"L Lei","year":"2007","unstructured":"Lei, L., Song, Y. & Chen, R. Biomechanical properties of prolapsed vaginal tissue in pre-and postmenopausal women. Int. Urogynecol. J. 18, 603\u2013607 (2007).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR9","doi-asserted-by":"publisher","first-page":"20956","DOI":"10.1038\/s41598-021-00351-1","volume":"11","author":"GL Clark-Patterson","year":"2021","unstructured":"Clark-Patterson, G. L. et al. Role of fibulin-5 insufficiency and prolapse progression on murine vaginal Biomechanical function. Sci. Rep. 11, 20956 (2021).","journal-title":"Sci. Rep."},{"key":"11094_CR10","doi-asserted-by":"publisher","first-page":"e917","DOI":"10.1016\/j.urology.2011.11.010","volume":"79","author":"C Rubod","year":"2012","unstructured":"Rubod, C. et al. Biomechanical properties of human pelvic organs. Urology 79, e917\u2013968 (2012). 968.","journal-title":"Urology"},{"key":"11094_CR11","doi-asserted-by":"publisher","first-page":"1535","DOI":"10.1007\/s00192-010-1208-z","volume":"21","author":"C Jean-Charles","year":"2010","unstructured":"Jean-Charles, C. et al. Biomechanical properties of prolapsed or non-prolapsed vaginal tissue: Impact on genital prolapse surgery. Int. Urogynecol. J. 21, 1535\u20131538 (2010).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR12","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1016\/S1350-4533(98)00026-5","volume":"20","author":"G Ettema","year":"1998","unstructured":"Ettema, G., Goh, J. & Forwood, M. A new method to measure elastic properties of plastic-viscoelastic connective tissue. Med. Eng. Phys. 20, 308\u2013314 (1998).","journal-title":"Med. Eng. Phys."},{"key":"11094_CR13","doi-asserted-by":"crossref","unstructured":"Epstein, L. B., Graham, C. A. & Heit, M. H. Systemic and vaginal biomechanical properties of women with normal vaginal support and pelvic organ prolapse. Am. J. Obstet. Gynecol 197, 165 (2007).","DOI":"10.1016\/j.ajog.2007.03.040"},{"key":"11094_CR14","doi-asserted-by":"crossref","unstructured":"Rahn, D. D., Ruff, M. D., Brown, S. A., Tibbals, H. F. & Word, R. A. Biomechanical properties of the vaginal wall: Effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse. Am. J. Obstet. Gynecol 198, 590 (2008).","DOI":"10.1016\/j.ajog.2008.02.022"},{"key":"11094_CR15","doi-asserted-by":"publisher","first-page":"201","DOI":"10.1016\/S0301-2115(03)00333-6","volume":"112","author":"M Cosson","year":"2004","unstructured":"Cosson, M. et al. A Biomechanical study of the strength of vaginal tissues: Results on 16 post-menopausal patients presenting with genital prolapse. Eur. J. Obstet. Gynecol. Reprod. Biol. 112, 201\u2013205 (2004).","journal-title":"Eur. J. Obstet. Gynecol. Reproductive Biology"},{"key":"11094_CR16","doi-asserted-by":"publisher","first-page":"499","DOI":"10.1002\/nau.22968","volume":"36","author":"R Eberhart","year":"2017","unstructured":"Eberhart, R., Chuong, C. J. & Zimmern, P. Exploring Biomechanical methods to study the human vaginal wall. Neurourol. Urodyn. 36, 499\u2013506 (2017).","journal-title":"Neurourol. Urodyn."},{"key":"11094_CR17","doi-asserted-by":"publisher","first-page":"061010","DOI":"10.1115\/1.4054362","volume":"144","author":"SE White","year":"2022","unstructured":"White, S. E., Kiley, J. X., Visniauskas, B., Lindsey, S. H. & Miller, K. S. Biaxial murine vaginal remodeling with reproductive aging. J. Biomech. Eng. 144, 061010 (2022).","journal-title":"J. Biomech. Eng."},{"key":"11094_CR18","doi-asserted-by":"publisher","first-page":"121008","DOI":"10.1115\/1.4052365","volume":"143","author":"GL Clark-Patterson","year":"2021","unstructured":"Clark-Patterson, G. L. et al. Investigation of murine vaginal creep response to altered mechanical loads. J. Biomech. Eng. 143, 121008 (2021).","journal-title":"J. Biomech. Eng."},{"key":"11094_CR19","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1016\/j.jmbbm.2010.10.006","volume":"4","author":"E Pe\u00f1a","year":"2011","unstructured":"Pe\u00f1a, E. et al. Mechanical characterization of the softening behavior of human vaginal tissue. J. Mech. Behav. Biomed. Mater. 4, 275\u2013283 (2011).","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"11094_CR20","doi-asserted-by":"publisher","first-page":"7386","DOI":"10.1038\/s41598-020-64192-0","volume":"10","author":"EK Danso","year":"2020","unstructured":"Danso, E. K. et al. Comparison of biaxial biomechanical properties of post-menopausal human prolapsed and non-prolapsed uterosacral ligament. Sci. Rep. 10, 7386 (2020).","journal-title":"Sci. Rep."},{"key":"11094_CR21","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/S0002-9378(96)70243-0","volume":"175","author":"RC Bump","year":"1996","unstructured":"Bump, R. C. et al. The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am. J. Obstet. Gynecol. 175, 10\u201317 (1996).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"11094_CR22","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1007\/s11340-018-00457-0","volume":"59","author":"J Yang","year":"2019","unstructured":"Yang, J. & Bhattacharya, K. Augmented lagrangian digital image correlation. Exp. Mech. 59, 187\u2013205 (2019).","journal-title":"Exp. Mech."},{"key":"11094_CR23","doi-asserted-by":"publisher","first-page":"2011","DOI":"10.1007\/s00192-013-2111-1","volume":"24","author":"L De Landsheere","year":"2013","unstructured":"De Landsheere, L. et al. Histology of the vaginal wall in women with pelvic organ prolapse: A literature review. Int. Urogynecol. J. 24, 2011\u20132020 (2013).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR24","doi-asserted-by":"crossref","unstructured":"Fratzl, P. In Collagen: Structure and Mechanics 1\u201313 (Springer, 2008).","DOI":"10.1007\/978-0-387-73906-9_1"},{"key":"11094_CR25","doi-asserted-by":"publisher","first-page":"47","DOI":"10.1016\/j.matbio.2019.10.001","volume":"85","author":"C Wang","year":"2020","unstructured":"Wang, C. et al. Type III collagen is a key regulator of the collagen fibrillar structure and biomechanics of articular cartilage and meniscus. Matrix Biol. 85, 47\u201367 (2020).","journal-title":"Matrix Biol."},{"key":"11094_CR26","first-page":"423","volume":"187","author":"A Cribb","year":"1995","unstructured":"Cribb, A. & Scott, J. Tendon response to tensile stress: An ultrastructural investigation of collagen: proteoglycan interactions in stressed tendon. J. Anat. 187, 423 (1995).","journal-title":"J. Anat."},{"key":"11094_CR27","doi-asserted-by":"publisher","first-page":"1596","DOI":"10.1002\/jor.20938","volume":"27","author":"SP Lake","year":"2009","unstructured":"Lake, S. P., Miller, K. S., Elliott, D. M. & Soslowsky, L. J. Effect of fiber distribution and realignment on the nonlinear and inhomogeneous mechanical properties of human supraspinatus tendon under longitudinal tensile loading. J. Orthop. Res. 27, 1596\u20131602 (2009).","journal-title":"J. Orthop. Res."},{"key":"11094_CR28","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1016\/j.jbiomech.2019.07.011","volume":"94","author":"CK Conway","year":"2019","unstructured":"Conway, C. K. et al. Biaxial Biomechanical properties of the nonpregnant murine cervix and uterus. J. Biomech. 94, 39\u201348 (2019).","journal-title":"J. Biomech."},{"key":"11094_CR29","doi-asserted-by":"publisher","first-page":"104504","DOI":"10.1115\/1.4037559","volume":"139","author":"KM Robison","year":"2017","unstructured":"Robison, K. M., Conway, C. K., Desrosiers, L., Knoepp, L. R. & Miller, K. S. Biaxial mechanical assessment of the murine vaginal wall using extension\u2013inflation testing. J. Biomech. Eng. 139, 104504 (2017).","journal-title":"J. Biomech. Eng."},{"key":"11094_CR30","doi-asserted-by":"publisher","first-page":"e103363","DOI":"10.1371\/journal.pone.0103363","volume":"9","author":"C Wan","year":"2014","unstructured":"Wan, C., Hao, Z., Wen, S. & Leng, H. A quantitative study of the relationship between the distribution of different types of collagen and the mechanical behavior of rabbit medial collateral ligaments. PLoS One 9, e103363 (2014).","journal-title":"PLoS One"},{"key":"11094_CR31","doi-asserted-by":"publisher","first-page":"1221","DOI":"10.1114\/1.1527047","volume":"30","author":"TT Tower","year":"2002","unstructured":"Tower, T. T., Neidert, M. R. & Tranquillo, R. T. Fiber alignment imaging during mechanical testing of soft tissues. Ann. Biomed. Eng. 30, 1221\u20131233 (2002).","journal-title":"Ann. Biomed. Eng."},{"key":"11094_CR32","doi-asserted-by":"publisher","first-page":"0084","DOI":"10.1038\/s41551-017-0084","volume":"1","author":"AK Glaser","year":"2017","unstructured":"Glaser, A. K. et al. Light-sheet microscopy for slide-free non-destructive pathology of large clinical specimens. Nat. Biomed. Eng. 1, 0084 (2017).","journal-title":"Nat. Biomedical Eng."},{"key":"11094_CR33","doi-asserted-by":"publisher","first-page":"2532","DOI":"10.1038\/s41598-022-06501-3","volume":"12","author":"GS Sangha","year":"2022","unstructured":"Sangha, G. S. et al. Assessment of photoacoustic tomography contrast for breast tissue imaging using 3D correlative virtual histology. Sci. Rep. 12, 2532 (2022).","journal-title":"Sci. Rep."},{"key":"11094_CR34","doi-asserted-by":"crossref","unstructured":"Timin, G. & Milinkovitch, M. C. High-resolution confocal and light-sheet imaging of collagen 3D network architecture in very large samples. iScience 26 (2023).","DOI":"10.1016\/j.isci.2023.106452"},{"key":"11094_CR35","doi-asserted-by":"publisher","first-page":"275","DOI":"10.1097\/PAI.0b013e31826d81db","volume":"21","author":"CH Liu","year":"2013","unstructured":"Liu, C. H. et al. Melanin bleaching with dilute hydrogen peroxide: A simple and rapid method. Appl. Immunohistochem. Mol. Morphol. 21, 275\u2013279 (2013).","journal-title":"Appl. Immunohistochem. Mol. Morphology"},{"key":"11094_CR36","doi-asserted-by":"crossref","unstructured":"Bishop, K. W. et al. An end-to-end workflow for nondestructive 3D pathology. Nat. Protocols 1\u201327 (2024).","DOI":"10.1038\/s41596-023-00934-4"},{"key":"11094_CR37","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1002\/cyto.a.22264","volume":"83","author":"E Biela","year":"2013","unstructured":"Biela, E. et al. Col-F, a fluorescent probe for ex vivo confocal imaging of collagen and Elastin in animal tissues. Cytom. Part A 83, 533\u2013539 (2013).","journal-title":"Cytometry Part. A"},{"key":"11094_CR38","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1038\/nmeth.1476","volume":"7","author":"PJ Keller","year":"2010","unstructured":"Keller, P. J. et al. Fast, high-contrast imaging of animal development with scanned light sheet\u2013based structured-illumination microscopy. Nat. Methods 7, 637\u2013642 (2010).","journal-title":"Nat. Methods"},{"key":"11094_CR39","doi-asserted-by":"publisher","first-page":"3833","DOI":"10.1364\/BOE.10.003833","volume":"10","author":"B Hu","year":"2019","unstructured":"Hu, B., Li, G. & Brown, J. Q. Enhanced resolution 3D digital cytology and pathology with dual-view inverted selective plane illumination microscopy. Biomed. Opt. Express 10, 3833\u20133846 (2019).","journal-title":"Biomedical Opt. Express"},{"key":"11094_CR40","unstructured":"Li, G., Hu, B. & Brown, J. Q. In Novel Techniques in Microscopy NW5C-5 (Optica Publishing Group)."},{"key":"11094_CR41","doi-asserted-by":"publisher","first-page":"e0165530","DOI":"10.1371\/journal.pone.0165530","volume":"11","author":"KN Elfer","year":"2016","unstructured":"Elfer, K. N. et al. DRAQ5 and Eosin (\u2018D&E\u2019) as an analog to hematoxylin and Eosin for rapid fluorescence histology of fresh tissues. PLoS One 11, e0165530 (2016).","journal-title":"PLoS One"},{"key":"11094_CR42","doi-asserted-by":"publisher","first-page":"e0233198","DOI":"10.1371\/journal.pone.0233198","volume":"15","author":"R Serafin","year":"2020","unstructured":"Serafin, R., Xie, W., Glaser, A. K. & Liu, J. T. FalseColor-Python: A rapid intensity-leveling and digital-staining package for fluorescence-based slide-free digital pathology. Plos One 15, e0233198 (2020).","journal-title":"Plos One"},{"key":"11094_CR43","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1097\/00004728-199811000-00014","volume":"22","author":"Y Sato","year":"1998","unstructured":"Sato, Y., Shiraga, N., Nakajima, S., Tamura, S. & Kikinis, R. Local maximum intensity projection (LMIP): A new rendering method for vascular visualization. J. Comput. Assist. Tomogr. 22, 912\u2013917. https:\/\/doi.org\/10.1097\/00004728-199811000-00014 (1998).","journal-title":"J. Comput. Assist. Tomogr"},{"key":"11094_CR44","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/0734-189X(85)90133-1","volume":"29","author":"WH Tsai","year":"1985","unstructured":"Tsai, W. H. Moment-preserving thresolding: A new approach. Comput. Vis. Graph. Image Process. 29, 377\u2013393 (1985).","journal-title":"Comput. Vis. Graphics Image Process."},{"key":"11094_CR45","doi-asserted-by":"publisher","first-page":"549","DOI":"10.1007\/s10439-010-0153-9","volume":"39","author":"A Feola","year":"2011","unstructured":"Feola, A. et al. Impact of pregnancy and vaginal delivery on the passive and active mechanics of the rat vagina. Ann. Biomed. Eng. 39, 549\u2013558 (2011).","journal-title":"Ann. Biomed. Eng."},{"key":"11094_CR46","doi-asserted-by":"crossref","unstructured":"Zhang, Y. et al. A compact fiber-optic SHG scanning endomicroscope and its application to visualize cervical remodeling during pregnancy. Proc. Natl. Acad. Sci. 109, 12878\u201312883 (2012).","DOI":"10.1073\/pnas.1121495109"},{"key":"11094_CR47","doi-asserted-by":"publisher","first-page":"521","DOI":"10.1095\/biolreprod.107.063024","volume":"78","author":"CK Wieslander","year":"2008","unstructured":"Wieslander, C. K. et al. Regulation of elastolytic proteases in the mouse vagina during pregnancy, parturition, and puerperium. Biol. Reprod. 78, 521\u2013528 (2008).","journal-title":"Biol. Reprod."},{"key":"11094_CR48","doi-asserted-by":"publisher","first-page":"630","DOI":"10.1016\/S0344-0338(11)80070-1","volume":"188","author":"A Mauriello","year":"1992","unstructured":"Mauriello, A. et al. Age-related modification of average volume and anisotropy of vascular smooth muscle cells. Pathol. Res. Pract. 188, 630\u2013636 (1992).","journal-title":"Pathology-Research Pract."},{"key":"11094_CR49","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1007\/s10439-018-02117-9","volume":"47","author":"A Huntington","year":"2019","unstructured":"Huntington, A., Rizzuto, E., Abramowitch, S., Del Prete, Z. & De Vita, R. Anisotropy of the passive and active rat vagina under biaxial loading. Ann. Biomed. Eng. 47, 272\u2013281 (2019).","journal-title":"Ann. Biomed. Eng."},{"key":"11094_CR50","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1016\/j.actbio.2022.08.059","volume":"152","author":"N Chi","year":"2022","unstructured":"Chi, N. et al. Distinctive structure, composition and biomechanics of collagen fibrils in vaginal wall connective tissues associated with pelvic organ prolapse. Acta Biomater. 152, 335\u2013344 (2022).","journal-title":"Acta Biomater."},{"key":"11094_CR51","doi-asserted-by":"publisher","first-page":"021011","DOI":"10.1115\/1.4042014","volume":"141","author":"AR Akintunde","year":"2019","unstructured":"Akintunde, A. R. et al. Effects of elastase digestion on the murine vaginal wall biaxial mechanical response. J. Biomech. Eng. 141, 021011 (2019).","journal-title":"J. Biomech. Eng."},{"key":"11094_CR52","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.jmbbm.2015.09.023","volume":"58","author":"M Brieu","year":"2016","unstructured":"Brieu, M. et al. A nonlinear-elastic constitutive model for soft connective tissue based on a histologic description: Application to female pelvic soft tissue. J. Mech. Behav. Biomed. Mater. 58, 65\u201374 (2016).","journal-title":"J. Mech. Behav. Biomed. Mater."},{"key":"11094_CR53","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1007\/s00192-008-0737-1","volume":"20","author":"M Kerkhof","year":"2009","unstructured":"Kerkhof, M., Hendriks, L. & Br\u00f6lmann, H. Changes in connective tissue in patients with pelvic organ prolapse\u2014a review of the current literature. Int. Urogynecol. J. 20, 461\u2013474 (2009).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR54","doi-asserted-by":"publisher","first-page":"5","DOI":"10.26502\/fccm.92920302","volume":"7","author":"D Singh","year":"2023","unstructured":"Singh, D., Rai, V. & Agrawal, D. K. Regulation of collagen I and collagen III in tissue injury and regeneration. Cardiol. Cardiovasc. Med. 7, 5 (2023).","journal-title":"Cardiol. Cardiovasc. Med."},{"key":"11094_CR55","doi-asserted-by":"publisher","first-page":"953","DOI":"10.1097\/01.AOG.0000182584.15087.dd","volume":"106","author":"PA Moalli","year":"2005","unstructured":"Moalli, P. A., Shand, S. H., Zyczynski, H. M., Gordy, S. C. & Meyn, L. A. Remodeling of vaginal connective tissue in patients with prolapse. Obstet. Gynecol. 106, 953\u2013963 (2005).","journal-title":"Obstet. Gynecol."},{"key":"11094_CR56","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1007\/s001920200076","volume":"13","author":"C Takano","year":"2002","unstructured":"Takano, C. et al. Analysis of collagen in parametrium and vaginal apex of women with and without uterine prolapse. Int. Urogynecol. J. 13, 342\u2013345 (2002).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR57","first-page":"213","volume":"24","author":"C Zeng","year":"2018","unstructured":"Zeng, C. et al. Correlation between autophagy and collagen deposition in patients with pelvic organ prolapse. Urogynecology 24, 213\u2013221 (2018).","journal-title":"Urogynecology"},{"key":"11094_CR58","doi-asserted-by":"publisher","first-page":"1658","DOI":"10.1016\/S0140-6736(96)91489-0","volume":"347","author":"S Jackson","year":"1996","unstructured":"Jackson, S. et al. Changes in metabolism of collagen in genitourinary prolapse. Lancet 347, 1658\u20131661 (1996).","journal-title":"Lancet"},{"key":"11094_CR59","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1016\/j.ejogrb.2010.12.043","volume":"156","author":"M Dviri","year":"2011","unstructured":"Dviri, M., Leron, E., Dreiher, J., Mazor, M. & Shaco-Levy, R. Increased matrix metalloproteinases-1,-9 in the uterosacral ligaments and vaginal tissue from women with pelvic organ prolapse. Eur. J. Obstet. Gynecol. Reprod. Biol. 156, 113\u2013117 (2011).","journal-title":"Eur. J. Obstet. Gynecol. Reproductive Biology"},{"key":"11094_CR60","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1159\/000343230","volume":"75","author":"P Martins","year":"2013","unstructured":"Martins, P. et al. Biomechanical properties of vaginal tissue in women with pelvic organ prolapse. Gynecol. Obstet. Invest. 75, 85\u201392 (2013).","journal-title":"Gynecol. Obstet. Invest."},{"key":"11094_CR61","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1007\/s00192-008-0690-z","volume":"19","author":"P Takacs","year":"2008","unstructured":"Takacs, P., Gualtieri, M., Nassiri, M., Candiotti, K. & Medina, C. A. Vaginal smooth muscle cell apoptosis is increased in women with pelvic organ prolapse. Int. Urogynecol. J. 19, 1559\u20131564 (2008).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR62","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1159\/000495348","volume":"84","author":"L Hympanova","year":"2019","unstructured":"Hympanova, L. et al. Morphological and functional changes in the vagina following critical lifespan events in the Ewe. Gynecol. Obstet. Invest. 84, 360\u2013368 (2019).","journal-title":"Gynecol. Obstet. Invest."},{"key":"11094_CR63","doi-asserted-by":"crossref","unstructured":"Mao, M., Li, Y., Zhang, Y., Kang, J. & Zhu, L. Tissue composition and biomechanical property changes in the vaginal wall of ovariectomized young rats. BioMed Res. Int. 2019, 8921284 (2019).","DOI":"10.1155\/2019\/8921284"},{"key":"11094_CR64","doi-asserted-by":"publisher","first-page":"745","DOI":"10.14740\/jocmr4006","volume":"11","author":"RL Binder","year":"2019","unstructured":"Binder, R. L. et al. Histological and gene expression analysis of the effects of menopause status and hormone therapy on the vaginal introitus and labia majora. J. Clin. Med. Res. 11, 745 (2019).","journal-title":"J. Clin. Med. Res."},{"key":"11094_CR65","doi-asserted-by":"crossref","unstructured":"Gimenez, C., Alperin, M. & De Vita, R. The effect of menopause on vaginal tissue mechanics: A brief review. J. Biomech. Eng. 146 (2024).","DOI":"10.1115\/1.4063101"},{"key":"11094_CR66","doi-asserted-by":"crossref","unstructured":"Kerkhof, M. H. et al. Changes in tissue composition of the vaginal wall of premenopausal women with prolapse. Am. J. Obstet. Gynecol. 210, 168 (2014).","DOI":"10.1016\/j.ajog.2013.10.881"},{"key":"11094_CR67","doi-asserted-by":"publisher","first-page":"1909","DOI":"10.1007\/s10439-021-02760-9","volume":"49","author":"S Dahal","year":"2021","unstructured":"Dahal, S. et al. Quantitative morphometry of elastic fibers in pelvic organ prolapse. Ann. Biomed. Eng. 49, 1909\u20131922 (2021).","journal-title":"Ann. Biomed. Eng."},{"key":"11094_CR68","doi-asserted-by":"publisher","first-page":"1765","DOI":"10.1007\/s00192-021-05066-5","volume":"33","author":"K Allen-Brady","year":"2022","unstructured":"Allen-Brady, K., Bortolini, M. A. & Damaser, M. S. Mouse knockout models for pelvic organ prolapse: A systematic review. Int. Urogynecol. J. 33, 1765\u20131788 (2022).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR69","doi-asserted-by":"publisher","first-page":"186","DOI":"10.1016\/j.actbio.2023.12.035","volume":"175","author":"SE White","year":"2024","unstructured":"White, S. E. et al. Remodeling of murine vaginal smooth muscle function with reproductive age and elastic fiber disruption. Acta Biomater. 175, 186\u2013198 (2024).","journal-title":"Acta Biomater."},{"key":"11094_CR70","first-page":"1535","volume":"87","author":"ZG Guvatova","year":"2022","unstructured":"Guvatova, Z. G., Borisov, P. V., Alekseev, A. A. & Moskalev, A. A. Age-related changes in extracellular matrix. Biochemistry 87, 1535\u20131551 (2022).","journal-title":"Biochemistry"},{"key":"11094_CR71","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1007\/s00192-006-0090-1","volume":"18","author":"SY Lin","year":"2007","unstructured":"Lin, S. Y. et al. Changes in the extracellular matrix in the anterior vagina of women with or without prolapse. Int. Urogynecol. J. 18, 43\u201348 (2007).","journal-title":"Int. Urogynecol. J."},{"key":"11094_CR72","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1016\/j.juro.2012.05.017","volume":"188","author":"L Zhou","year":"2012","unstructured":"Zhou, L. et al. Biomechanical properties and associated collagen composition in vaginal tissue of women with pelvic organ prolapse. J. Urol. 188, 875\u2013880 (2012).","journal-title":"J. Urol."},{"key":"11094_CR73","doi-asserted-by":"crossref","unstructured":"Moreau, K. L. & Hildreth, K. L. Vascular aging across the menopause transition in healthy women. Adv. Vasc. Med. 2014, 204390 (2014).","DOI":"10.1155\/2014\/204390"},{"key":"11094_CR74","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1016\/j.bpobgyn.2013.06.004","volume":"27","author":"J Calleja-Agius","year":"2013","unstructured":"Calleja-Agius, J., Brincat, M. & Borg, M. Skin connective tissue and ageing. Best Pract. Res. Clin. Obstet. Gynecol. 27, 727\u2013740 (2013).","journal-title":"Best Pract. Res. Clin. Obstet. Gynecol."},{"key":"11094_CR75","doi-asserted-by":"publisher","first-page":"111193","DOI":"10.1016\/j.mad.2019.111193","volume":"185","author":"TL Reus","year":"2020","unstructured":"Reus, T. L., Brohem, C. A., Schuck, D. C. & Lorencini, M. Revisiting the effects of menopause on the skin: Functional changes, clinical studies, in vitro models and therapeutic alternatives. Mech. Ageing Dev. 185, 111193 (2020).","journal-title":"Mech. Ageing Dev."},{"key":"11094_CR76","doi-asserted-by":"publisher","first-page":"H1539","DOI":"10.1152\/ajpheart.1998.274.5.H1539","volume":"274","author":"RE De Meersman","year":"1998","unstructured":"De Meersman, R. E. et al. Estrogen replacement, vascular distensibility, and blood pressures in postmenopausal women. Am. J. Physiol. Heart Circ. Physiol. 274, H1539\u2013H1544 (1998).","journal-title":"Am. J. Physiol. Heart Circ. Physiol."},{"key":"11094_CR77","doi-asserted-by":"publisher","first-page":"2552","DOI":"10.1161\/STROKEAHA.108.528091","volume":"40","author":"E Fonck","year":"2009","unstructured":"Fonck, E. et al. Effect of aging on elastin functionality in human cerebral arteries. Stroke 40, 2552\u20132556 (2009).","journal-title":"Stroke"},{"key":"11094_CR78","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/S0021-9150(96)05947-3","volume":"127","author":"A Br\u00fcel","year":"1996","unstructured":"Br\u00fcel, A. & Oxlund, H. Changes in Biomechanical properties, composition of collagen and elastin, and advanced glycation endproducts of the rat aorta in relation to age. Atherosclerosis 127, 155\u2013165 (1996).","journal-title":"Atherosclerosis"},{"key":"11094_CR79","doi-asserted-by":"publisher","first-page":"20190025","DOI":"10.1098\/rsfs.2019.0025","volume":"9","author":"GL Clark","year":"2019","unstructured":"Clark, G. L. et al. Smooth muscle regional contribution to vaginal wall function. Interface Focus 9, 20190025 (2019).","journal-title":"Interface Focus"},{"key":"11094_CR80","doi-asserted-by":"publisher","first-page":"021011","DOI":"10.1115\/1.4023437","volume":"135","author":"JS Wilson","year":"2013","unstructured":"Wilson, J. S., Virag, L., Di Achille, P., Kar\u0161aj, I. & Humphrey, J. D. Biochemomechanics of intraluminal thrombus in abdominal aortic aneurysms. J. Biomech. Eng. 135, 021011 (2013).","journal-title":"J. Biomech. Eng."},{"key":"11094_CR81","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1007\/s13239-017-0301-6","volume":"8","author":"JS Wilson","year":"2017","unstructured":"Wilson, J. S., Bersi, M. R., Li, G. & Humphrey, J. D. Correlation of wall microstructure and heterogeneous distributions of strain in evolving murine abdominal aortic aneurysms. Cardiovasc. Eng. Technol. 8, 193\u2013204 (2017).","journal-title":"Cardiovasc. Eng. Technol."},{"key":"11094_CR82","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1038\/srep22971","volume":"6","author":"AM Ruiz-Zapata","year":"2016","unstructured":"Ruiz-Zapata, A. M. et al. Vaginal fibroblastic cells from women with pelvic organ prolapse produce matrices with increased stiffness and collagen content. Sci. Rep. 6, 1\u20139 (2016).","journal-title":"Sci. Rep."},{"key":"11094_CR83","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1067\/mob.2002.124843","volume":"187","author":"MK Boreham","year":"2002","unstructured":"Boreham, M. K., Wai, C. Y., Miller, R. T., Schaffer, J. I. & Word, R. A. Morphometric analysis of smooth muscle in the anterior vaginal wall of women with pelvic organ prolapse. Am. J. Obstet. Gynecol. 187, 56\u201363 (2002).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"11094_CR84","doi-asserted-by":"publisher","first-page":"1501","DOI":"10.1067\/mob.2002.130005","volume":"187","author":"MK Boreham","year":"2002","unstructured":"Boreham, M. K., Wai, C. Y., Miller, R. T., Schaffer, J. I. & Word, R. A. Morphometric properties of the posterior vaginal wall in women with pelvic organ prolapse. Am. J. Obstet. Gynecol. 187, 1501\u20131509 (2002).","journal-title":"Am. J. Obstet. Gynecol."},{"key":"11094_CR85","doi-asserted-by":"publisher","first-page":"1219","DOI":"10.1111\/jsm.12088","volume":"10","author":"ME Basha","year":"2013","unstructured":"Basha, M. E. et al. Effect of Estrogen on molecular and functional characteristics of the rodent vaginal muscularis. J. Sex. Med. 10, 1219\u20131230 (2013).","journal-title":"J. Sex. Med."},{"key":"11094_CR86","doi-asserted-by":"publisher","first-page":"627","DOI":"10.1097\/AOG.0b013e31820afaf2","volume":"117","author":"HJ Landy","year":"2011","unstructured":"Landy, H. J. et al. Characteristics associated with severe perineal and cervical lacerations during vaginal delivery. Obstet. Gynecol. 117, 627\u2013635 (2011).","journal-title":"Obstet. Gynecol."},{"issue":"1","key":"11094_CR87","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1038\/s44294-024-00047-7","volume":"3","author":"J Dubik","year":"2025","unstructured":"Dubik, J. et al. The biomechanics of the vagina: A complete review of incomplete data. npj Womens Health 3(1), 3. https:\/\/doi.org\/10.1038\/s44294-024-00047-7 (2025). (2025-01-27).","journal-title":"Npj Women\u2019s Health"},{"key":"11094_CR88","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1002\/jum.16422","volume":"43","author":"JA Garc\u00eda-Mejido","year":"2024","unstructured":"Garc\u00eda-Mejido, J. A. et al. The application of shear wave elastography to determine the elasticity of the levator Ani muscle and vaginal tissue in patients with pelvic organ prolapse. J. Ultrasound Med. 43, 913\u2013921 (2024).","journal-title":"J. Ultrasound Med."},{"key":"11094_CR89","doi-asserted-by":"publisher","first-page":"28","DOI":"10.34057\/PPj.2023.42.01.2022-5-2","volume":"42","author":"N Sarvazyan","year":"2023","unstructured":"Sarvazyan, N., Francy, B. & Egorov, V. Vaginal tactile imaging: A review. Pelviperineology 42, 28 (2023).","journal-title":"Pelviperineology"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11094-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11094-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11094-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T22:50:31Z","timestamp":1757285431000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-11094-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,7,25]]},"references-count":89,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["11094"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-11094-8","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,7,25]]},"assertion":[{"value":"6 February 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 July 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 July 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"J. Q. B. is a co-founder and has financial interest in Instapath, Inc. Other authors have no competing interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"27039"}}