{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T11:02:43Z","timestamp":1781348563169,"version":"3.54.1"},"reference-count":33,"publisher":"ASME International","issue":"9","content-domain":{"domain":["asmedigitalcollection.asme.org"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2015,9,1]]},"abstract":"<jats:p>Dynamic behaviors of the single-incision sling (SIS) to correct urethral hypermobility are investigated via dynamic biomechanical analysis using a computational model of the female pelvis, developed from a female subject's high-resolution magnetic resonance (MR) images. The urethral hypermobility is simulated by weakening the levator ani muscle in the pelvic model. Four positions along the posterior urethra (proximal, midproximal, middle, and mid-distal) were considered for sling implantation. The \u03b1-angle, urethral excursion angle, and sling\u2013urethra interaction force generated during Valsalva maneuver were quantitatively characterized to evaluate the effect of the sling implantation position on treatment outcomes and potential complications. Results show concern for overcorrection with a sling implanted at the bladder neck, based on a relatively larger sling\u2013urethra interaction force of 1.77\u2009N at the proximal implantation position (compared with 0.25\u2009N at mid-distal implantation position). A sling implanted at the mid-distal urethral location provided sufficient correction (urethral excursion angle of 23.8\u2009deg after mid-distal sling implantation versus 24.4\u2009deg in the intact case) with minimal risk of overtightening and represents the optimal choice for sling surgery. This study represents the first effort utilizing a comprehensive pelvic model to investigate the performance of an implanted sling to correct urethral hypermobility. The computational modeling approach presented in the study can also be used to advance presurgery planning, sling product design, and to enhance our understanding of various surgical risk factors which are difficult to obtain in clinical practice.<\/jats:p>","DOI":"10.1115\/1.4030978","type":"journal-article","created":{"date-parts":[[2015,7,4]],"date-time":"2015-07-04T04:31:03Z","timestamp":1435984263000},"update-policy":"https:\/\/doi.org\/10.1115\/crossmarkpolicy-asme","source":"Crossref","is-referenced-by-count":21,"title":["The Single-Incision Sling to Treat Female Stress Urinary Incontinence: A Dynamic Computational Study of Outcomes and Risk Factors"],"prefix":"10.1115","volume":"137","author":[{"given":"Yun","family":"Peng","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, University of Houston, E2003 SERC Building, 3605 Cullen Boulevard, Houston, TX 77204-5060 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rose","family":"Khavari","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital and Research Institute, 6565 Fannin Street, Suite 2100, Houston, TX 77030-2703 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nissrine A.","family":"Nakib","sequence":"additional","affiliation":[{"name":"Department of Urology, University of Minnesota, 420 Delaware Street, SE MMC 394, Minneapolis, MN 55455-0341 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie N.","family":"Stewart","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital and Research Institute, 6565 Fannin Street, Suite 2100, Houston, TX 77030-2703 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy B.","family":"Boone","sequence":"additional","affiliation":[{"name":"Department of Urology, Houston Methodist Hospital and Research Institute, 6565 Fannin Street, Suite 2100, Houston, TX 77030-2703 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingchun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Houston, 2027 SERC Building, 3605 Cullen Boulevard, Houston, TX 77204-5060 e-mail:"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"33","reference":[{"issue":"5","key":"2019100600542882700_B1","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1007\/s11934-011-0209-x","article-title":"The Financial Burden of Stress Urinary Incontinence Among Women in the United States","volume":"12","year":"2011","journal-title":"Curr. 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