title: Histo-mechanical properties of the swine cardinal and uterosacral ligaments.
abstract: The focus of this study was to determine the structural and mechanical properties of two major ligaments that support the uterus, cervix, and vagina: the cardinal ligament (CL) and the uterosacral ligament (USL). The adult swine was selected as animal model. Histological analysis was performed on longitudinal and cross sections of CL and USL specimens using Masson׳s trichrome and Verhoeff-van Giesson staining methods. Scanning electron microscopy was employed to visualize the through-thickness organization of the collagen fibers. Quasi-static uniaxial tests were conducted on specimens that were harvested from the CL/USL complex of a single swine. Dense connective tissue with a high content of elastin and collagen fibers was observed in the USL. Loose connective tissue with a considerable amount of smooth muscle cells and ground substance was detected in both the CL and USL. Collagen fibers, smooth muscle cells, blood vessels, and nerve fibers were arranged primarily in the plane of the ligaments. The USL was significantly stronger than the CL with higher ultimate stress and tangent modulus of the linear region of the stress-strain curve. Knowledge about the mechanical properties of the CL and USL will aid in the design of novel mesh materials, stretching routines, and surgical procedures for pelvic floor disorders.
authors.affiliation: Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA.
authors.forename: Ting
authors.initials: T
authors.lastname: Tan
authors.affiliation: Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA.
authors.forename: Frances M
authors.initials: FM
authors.lastname: Davis
authors.affiliation: Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, MD 20814, USA.
authors.forename: Daniel D
authors.initials: DD
authors.lastname: Gruber
authors.affiliation: Department of Urogynecology, Wright-Patterson Medical Center, Ohio, OH 45433, USA.
authors.forename: Jason C
authors.initials: JC
authors.lastname: Massengill
authors.affiliation: Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA.
authors.forename: John L
authors.initials: JL
authors.lastname: Robertson
authors.affiliation: Department of Biomedical Engineering and Mechanics, Virginia Tech, Blacksburg, VA 24061, USA. Electronic address: devita@vt.edu.
authors.forename: Raffaella
authors.initials: R
authors.lastname: De Vita
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D005260:Female; D008022:Ligaments / Q000166:cytology* / Q000502:physiology / Q000648:ultrastructure; D055595:Mechanical Phenomena; D008855:Microscopy, Electron, Scanning; D013314:Stress, Mechanical; D013552:Swine; D013718:Tensile Strength; D014599:Uterus / Q000166:cytology* / Q000502:physiology / Q000648:ultrastructure
keywords: Cardinal ligament; Histology; Mechanical testing; SEM; Tensile properties; Uterosacral ligament