{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T13:53:21Z","timestamp":1764251601274},"reference-count":61,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>The mechanical properties and microstructure of the perineal body are important for the improvement of numerical models of pelvic organs. We determined the mechanical parameters and volume fractions of the ewe perineal body as an animal model.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>The 39 specimens of 13 pregnant swifter ewes delivering by cesarean section (aged 2 years, weight 61.2\u200a\u00b1\u200a6.2\u200akg (mean\u200a\u00b1\u200astandard deviation) and 24 specimens of 8 postmenopausal swifter ewes 150 days after surgical ovariectomy (aged 7 years, 58.6\u200a\u00b1\u200a4.6\u200akg)) were loaded uniaxially to determine Young's moduli of elasticity in the small (E<jats:sub>0<\/jats:sub>) and large (E<jats:sub>1<\/jats:sub>) deformation regions, and ultimate stresses and strains. The 63 adjacent tissue samples were processed histologically to assess volume fractions of smooth and skeletal muscle, adipose cells, elastin, and type I collagen using a stereological point testing grid. We compared the structural and mechanical differences along the ewe perineal body, and between pregnant and postmenopausal groups.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The pregnant\/postmenopausal perineal body was composed of smooth muscle (12\/14%; median), skeletal muscle (12\/16%), collagen (10\/23%), elastin (8\/7%), and adipose cells (6\/6%). The E<jats:sub>0<\/jats:sub> was 37\/11\u200akPa (median), E<jats:sub>1<\/jats:sub> was 0.97\/1.04\u200aMPa, ultimate stress was 0.55\/0.59\u200aMPa, and ultimate strain was 0.90\/0.87 for pregnant\/postmenopausal perineal body. The perineal body showed a structural and mechanical stability across the sites. The pregnant ewes had a higher amount of skeletal muscle, higher E<jats:sub>0<\/jats:sub>, and a less amount of collagen when compared with postmenopausal ewes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>The data can be used as input for models simulating vaginal delivery, pelvic floor prolapsed, or dysfunction.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/gme.0000000000001395","type":"journal-article","created":{"date-parts":[[2019,9,11]],"date-time":"2019-09-11T10:08:35Z","timestamp":1568196515000},"page":"1289-1301","source":"Crossref","is-referenced-by-count":7,"title":["The histological microstructure and in vitro mechanical properties of pregnant and postmenopausal ewe perineal body"],"prefix":"10.1097","volume":"26","author":[{"given":"Petra","family":"Kochov\u00e1","sequence":"first","affiliation":[{"name":"European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic"}]},{"given":"Lucie","family":"Hymp\u00e1nov\u00e1","sequence":"additional","affiliation":[{"name":"Centre for Surgical Technologies, KU Leuven, Leuven, Belgium"},{"name":"Department of Development and Regeneration, KU Leuven, Leuven, Belgium"},{"name":"The Institute for the Care of Mother and Child, Third Faculty of Medicine, Charles University, Prague, Czech Republic"}]},{"given":"Rita","family":"Rynkevic","sequence":"additional","affiliation":[{"name":"Centre for Surgical Technologies, KU Leuven, Leuven, Belgium"},{"name":"Department of Development and Regeneration, KU Leuven, Leuven, Belgium"},{"name":"INEGI, Faculdade de Engenharia da Universidade do Porto, Porto, Portugal"}]},{"given":"Robert","family":"Cimrman","sequence":"additional","affiliation":[{"name":"European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic"}]},{"given":"Zbyn\u011bk","family":"Tonar","sequence":"additional","affiliation":[{"name":"European Centre of Excellence NTIS, Faculty of Applied Sciences, University of West Bohemia, Pilsen, Czech Republic"}]},{"given":"Jan","family":"Deprest","sequence":"additional","affiliation":[{"name":"Centre for Surgical Technologies, KU Leuven, Leuven, Belgium"},{"name":"Department of Development and Regeneration, KU Leuven, Leuven, Belgium"},{"name":"Pelvic Floor Unit, University Hospitals KU Leuven, Leuven, Belgium"}]},{"given":"Vladimir","family":"Kalis","sequence":"additional","affiliation":[{"name":"Biomedical Center, Faculty of Medicine, Charles University, Pilsen, Czech Republic"},{"name":"Department of Gynecology and Obstetrics, University Hospital, Pilsen, Czech Republic."}]}],"member":"276","published-online":{"date-parts":[[2019,11]]},"reference":[{"key":"R1-20230814","doi-asserted-by":"crossref","first-page":"2120","DOI":"10.1007\/s10350-007-9064-8","article-title":"A novel concept for the surgical anatomy of the perineal body","volume":"50","author":"Shafik","year":"2007","journal-title":"Dis Colon Rectum"},{"key":"R2-20230814","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1016\/j.bpg.2009.04.008","article-title":"Anorectal and pelvic floor anatomy","volume":"23","author":"Stoker","year":"2009","journal-title":"Best Pract Res Clin Gastroenterol"},{"key":"R3-20230814","article-title":"Williams Gynecology","year":"2016"},{"key":"R4-20230814","article-title":"Advances in Reconstructive Vaginal Surgery","year":"2012"},{"key":"R6-20230814","doi-asserted-by":"crossref","first-page":"455","DOI":"10.1016\/j.jbiomech.2011.12.002","article-title":"A subject-specific anisotropic visco-hyperelastic finite element model of female pelvic floor stress and strain during the second stage of labor","volume":"45","author":"Jing","year":"2012","journal-title":"J Biomech"},{"key":"R7-20230814","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s00192-007-0388-7","article-title":"Deformation of the pelvic floor muscles during a vaginal delivery","volume":"19","author":"Parente","year":"2008","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"R8-20230814","doi-asserted-by":"crossref","first-page":"1301","DOI":"10.1016\/j.jbiomech.2009.03.011","article-title":"The influence of the material properties on the biomechanical behavior of the pelvic floor muscles during vaginal delivery","volume":"42","author":"Parente","year":"2009","journal-title":"J Biomech"},{"key":"R9-20230814","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1097\/AOG.0b013e31819c82e1","article-title":"Biomechanical analyses of the efficacy of patterns of maternal effort on second-stage progress","volume":"113","author":"Lien","year":"2009","journal-title":"Obstet Gynecol"},{"key":"R10-20230814","first-page":"750","article-title":"Modelling childbirth: comparing athlete and non-athlete pelvic floor mechanics","volume":"11","author":"Li","year":"2008","journal-title":"Med Image Comput Comput Interv"},{"key":"R11-20230814","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1196\/annals.1389.019","article-title":"Finite element studies of the deformation of the pelvic floor","volume":"1101","author":"Martins","year":"2007","journal-title":"Ann N Y Acad Sci"},{"key":"R12-20230814","doi-asserted-by":"crossref","first-page":"125","DOI":"10.1007\/s13669-015-0115-1","article-title":"Finite element modeling in female pelvic floor medicine: a literature review","volume":"4","author":"Rostaminia","year":"2015","journal-title":"Curr Obstet Gynecol Rep"},{"key":"R13-20230814","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s00192-013-2164-1","article-title":"Modeling manual perineal protection during vaginal delivery","volume":"25","author":"Jansova","year":"2014","journal-title":"Int Urogynecol J"},{"key":"R14-20230814","doi-asserted-by":"crossref","first-page":"040801","DOI":"10.1115\/1.4030967","article-title":"Computational modeling of the female pelvic support structures and organs to understand the mechanism of pelvic organ prolapse: a review","volume":"67","author":"Chanda","year":"2015","journal-title":"Appl Mech Rev"},{"key":"R15-20230814","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.jbiomech.2009.04.043","article-title":"A 3D finite element model of anterior vaginal wall support to evaluate mechanisms underlying cystocele formation","volume":"42","author":"Chen","year":"2009","journal-title":"J Biomech"},{"key":"R16-20230814","first-page":"1","article-title":"Three-dimensional modeling of the pelvic floor support systems of subjects with and without pelvic organ prolapse","volume":"2015","author":"Ren","year":"2015","journal-title":"Biomed Res Int"},{"key":"R17-20230814","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1016\/j.jbiomech.2014.11.039","article-title":"Female patient-specific finite element modeling of pelvic organ prolapse (POP)","volume":"48","author":"Chen","year":"2015","journal-title":"J Biomech"},{"key":"R18-20230814","first-page":"1","article-title":"3D finite element modeling of pelvic organ prolapse","volume":"5842","author":"Yang","year":"2016","journal-title":"Comput Methods Biomech Biomed Engin"},{"key":"R19-20230814","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1007\/s10439-008-9471-6","article-title":"Anatomically realistic three-dimensional meshes of the pelvic floor and anal canal for finite element analysis","volume":"36","author":"Noakes","year":"2008","journal-title":"Ann Biomed Eng"},{"key":"R20-20230814","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1080\/10255840500405378","article-title":"A shell finite element model of the pelvic floor muscles","volume":"8","author":"D\u2019Aulignac","year":"2005","journal-title":"Comput Methods Biomech Biomed Engin"},{"key":"R21-20230814","first-page":"220","article-title":"FE simulation for the understanding of the median cystocele prolapse occurrence","volume":"44","author":"Mayeur","year":"2016","journal-title":"Biomed Simul"},{"key":"R23-20230814","doi-asserted-by":"crossref","first-page":"1575","DOI":"10.1016\/j.jbiomech.2015.02.056","article-title":"In vivo estimation of perineal body properties using ultrasound quasistatic elastography in nulliparous women","volume":"48","author":"Chen","year":"2015","journal-title":"J Biomech"},{"key":"R25-20230814","doi-asserted-by":"crossref","first-page":"060801","DOI":"10.1115\/1.4034442","article-title":"Mechanical properties of female reproductive organs and supporting connective tissues: A review of the current state of knowledge","volume":"68","author":"Baah-Dwomoh","year":"2016","journal-title":"Appl Mech Rev"},{"key":"R26-20230814","first-page":"360","article-title":"Subject specific finite element modelling of the levator ani","volume":"8","author":"Lee","year":"2005","journal-title":"Med Image Comput Comput Assist Interv"},{"key":"R27-20230814","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1097\/GME.0000000000001166","article-title":"The histological microstructure and in vitro mechanical properties of the human female postmenopausal perineal body","volume":"26","author":"Kochov\u00e1","year":"2019","journal-title":"Menopause"},{"issue":"(Suppl)","key":"R28-20230814","doi-asserted-by":"crossref","first-page":"S146","DOI":"10.1016\/j.ejogrb.2009.02.022","article-title":"Tissue mechanics, animal models, and pelvic organ prolapse: a review","volume":"144","author":"Abramowitch","year":"2009","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R30-20230814","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1159\/000454771","article-title":"Comparative anatomy of the ovine and female pelvis","volume":"82","author":"Urbankova","year":"2017","journal-title":"Gynecol Obstet Invest"},{"key":"R31-20230814","doi-asserted-by":"crossref","first-page":"e0189842","DOI":"10.1371\/journal.pone.0189842","article-title":"Fetal head size and effect of manual perineal protection","volume":"12","author":"Jansova","year":"2017","journal-title":"PLoS One"},{"key":"R32-20230814","doi-asserted-by":"crossref","first-page":"1153","DOI":"10.1016\/j.jbiomech.2005.02.012","article-title":"The effects of refreezing on the viscoelastic and tensile properties of ligaments","volume":"39","author":"Moon","year":"2006","journal-title":"J Biomech"},{"key":"R33-20230814","doi-asserted-by":"crossref","first-page":"968.e17\u2013e22","DOI":"10.1016\/j.urology.2011.11.010","article-title":"Biomechanical properties of human pelvic organs","volume":"79","author":"Rubod","year":"2012","journal-title":"Urology"},{"key":"R34-20230814","first-page":"6","article-title":"Comparative study on mechanical properties of the central portion of frozen and fresh calcaneus tendon","volume":"15","author":"de Menezes Reiff","year":"2007","journal-title":"Acta Ortop\u00e9dica Bras"},{"key":"R35-20230814","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s00192-007-0533-3","article-title":"Biomechanical properties of vaginal tissue: preliminary results","volume":"19","author":"Rubod","year":"2008","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"R36-20230814","doi-asserted-by":"crossref","first-page":"1806","DOI":"10.1016\/j.jbiomech.2006.07.005","article-title":"Mechanics of arterial subfailure with increasing loading rate","volume":"40","author":"Stemper","year":"2007","journal-title":"J Biomech"},{"key":"R39-20230814","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/j.1447-073x.2005.00109.x","article-title":"Surgical anatomy of the perineal muscles and their role in perineal disorders","volume":"80","author":"Shafik","year":"2005","journal-title":"Anat Sci Int"},{"key":"R40-20230814","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1097\/GME.0000000000000278","article-title":"Do stages of menopause affect the outcomes of pelvic floor muscle training?","volume":"22","author":"Tosun","year":"2014","journal-title":"Menopause"},{"key":"R41-20230814","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1111\/codi.13138","article-title":"The anatomy of the perineal body in relation to abdominoperineal excision for low rectal cancer","volume":"18","author":"Kraima","year":"2016","journal-title":"Colorectal Dis"},{"key":"R44-20230814","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.pmatsci.2007.05.002","article-title":"Biological materials: structure and mechanical properties","volume":"53","author":"Meyers","year":"2008","journal-title":"Prog Mater Sci"},{"key":"R46-20230814","doi-asserted-by":"crossref","first-page":"e44348","DOI":"10.1371\/journal.pone.0044348","article-title":"Elastic modulus of muscle and tendon with shear wave ultrasound elastography: variations with different technical settings","volume":"7","author":"Kot","year":"2012","journal-title":"PLoS One"},{"key":"R48-20230814","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.ultrasmedbio.2010.02.013","article-title":"Viscoelastic and anisotropic mechanical properties of in vivo muscle tissue assessed by supersonic shear imaging","volume":"36","author":"Gennisson","year":"2010","journal-title":"Ultrasound Med Biol"},{"key":"R49-20230814","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1007\/BF00538837","article-title":"Dynamic stiffness and crossbridge action in muscle","volume":"4","author":"Mason","year":"1978","journal-title":"Biophys Struct Mech"},{"key":"R50-20230814","doi-asserted-by":"crossref","first-page":"1577","DOI":"10.1088\/0031-9155\/40\/10\/002","article-title":"Elastic properties of human aortas in relation to age and atherosclerosis: a structural model","volume":"40","author":"Wuyts","year":"1995","journal-title":"Phys Med Biol"},{"key":"R51-20230814","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1016\/j.ijgo.2012.05.018","article-title":"Stereophotogrammetry of the perineum during vaginal delivery","volume":"119","author":"Zem\u010d\u00edk","year":"2012","journal-title":"Int J Gynaecol Obstet"},{"key":"R52-20230814","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1016\/j.jmbbm.2010.10.006","article-title":"Mechanical characterization of the softening behavior of human vaginal tissue","volume":"4","author":"Pe\u00f1a","year":"2011","journal-title":"J Mech Behav Biomed Mater"},{"key":"R53-20230814","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1016\/j.jbiomech.2008.12.002","article-title":"On modelling damage process in vaginal tissue","volume":"42","author":"Calvo","year":"2009","journal-title":"J Biomech"},{"key":"R54-20230814","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0301-2115(03)00333-6","article-title":"A biomechanical study of the strength of vaginal tissues","volume":"112","author":"Cosson","year":"2004","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"R55-20230814","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1007\/s10439-010-0153-9","article-title":"Impact of pregnancy and vaginal delivery on the passive and active mechanics of the rat vagina","volume":"39","author":"Feola","year":"2011","journal-title":"Ann Biomed Eng"},{"key":"R56-20230814","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1016\/j.jbiomech.2017.03.023","article-title":"Biomechanical and morphological properties of the multiparous ovine vagina and effect of subsequent pregnancy","volume":"57","author":"Rynkevic","year":"2017","journal-title":"J Biomech"},{"key":"R57-20230814","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1016\/j.ijplas.2008.06.001","article-title":"Modeling of anisotropic softening phenomena: application to soft biological tissues","volume":"25","author":"Ehret","year":"2009","journal-title":"Int J Plast"},{"key":"R58-20230814","doi-asserted-by":"crossref","first-page":"590e1","DOI":"10.1016\/j.ajog.2008.02.022","article-title":"Biomechanical properties of the vaginal wall: effect of pregnancy, elastic fiber deficiency, and pelvic organ prolapse","volume":"198","author":"Rahn","year":"2008","journal-title":"Am J Obstet Gynecol"},{"key":"R59-20230814","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1016\/j.aanat.2018.12.002","article-title":"The effect of consecutive pregnancies on the ovine pelvic soft tissues: link between biomechanical and histological components","volume":"222","author":"Rynkevic","year":"2019","journal-title":"Ann Anat"},{"key":"R60-20230814","doi-asserted-by":"crossref","first-page":"1724","DOI":"10.1016\/j.jbiomech.2012.04.001","article-title":"Dynamic material properties of the pregnant human uterus","volume":"45","author":"Manoogian","year":"2012","journal-title":"J Biomech"},{"key":"R61-20230814","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/0007-1935(91)90085-2","article-title":"Mechanical properties of the ovine cervix during pregnancy, labour and immediately after parturition","volume":"147","author":"Owiny","year":"1991","journal-title":"Br Vet J"},{"key":"R62-20230814","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1007\/s00192-014-2439-1","article-title":"Mechanical properties of pelvic soft tissue of young women and impact of aging","volume":"25","author":"Chantereau","year":"2014","journal-title":"Int Urogynecol J"},{"key":"R63-20230814","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1007\/s00192-010-1237-7","article-title":"Vagina abdominal skin, and aponeurosis: do they have similar biomechanical properties?","volume":"22","author":"Gabriel","year":"2011","journal-title":"Int Urogynecol J"},{"key":"R64-20230814","doi-asserted-by":"crossref","first-page":"e104972","DOI":"10.1371\/journal.pone.0104972","article-title":"Regional variation in tissue composition and biomechanical properties of postmenopausal ovine and human vagina","volume":"9","author":"Ulrich","year":"2014","journal-title":"PLoS One"},{"key":"R65-20230814","doi-asserted-by":"crossref","first-page":"165.e1","DOI":"10.1016\/j.ajog.2007.03.040","article-title":"Systemic and vaginal biomechanical properties of women with normal vaginal support and pelvic organ prolapse","volume":"197","author":"Epstein","year":"2007","journal-title":"Am J Obstet Gynecol"},{"key":"R66-20230814","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1007\/s00192-006-0214-7","article-title":"Biomechanical properties of prolapsed vaginal tissue in pre- and postmenopausal women","volume":"18","author":"Lei","year":"2007","journal-title":"Int Urogynecol J"},{"key":"R67-20230814","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1007\/s001920200019","article-title":"Biomechanical properties of prolapsed vaginal tissue in pre- and postmenopausal women","volume":"13","author":"Goh","year":"2002","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"R68-20230814","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/0021-9290(78)90009-X","article-title":"Passive mechanical properties of uterine muscle (myometrium) tested in vitro","volume":"11","author":"Pearsall","year":"1978","journal-title":"J Biomech"},{"key":"R69-20230814","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1007\/s00192-011-1409-0","article-title":"Uniaxial mechanical behavior of the human female bladder","volume":"22","author":"Martins","year":"2011","journal-title":"Int Urogynecol J"},{"key":"R70-20230814","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00192-012-1861-5","article-title":"Comparative analysis of pelvic ligaments: a biomechanics study","volume":"24","author":"Rivaux","year":"2013","journal-title":"Int Urogynecol J Pelvic Floor Dysfunct"},{"key":"R72-20230814","doi-asserted-by":"crossref","DOI":"10.1115\/1.4030967","article-title":"Computational modeling of the female pelvic support structures and organs to understand the mechanism of pelvic organ prolapse: a review","volume":"67","author":"Chanda","year":"2015","journal-title":"Appl Mech Rev"}],"container-title":["Menopause"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/GME.0000000000001395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,14]],"date-time":"2023-08-14T22:51:04Z","timestamp":1692053464000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/GME.0000000000001395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9,9]]},"references-count":61,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.1097\/gme.0000000000001395","relation":{},"ISSN":["1530-0374"],"issn-type":[{"value":"1530-0374","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,9,9]]}}}