title: Real-time measurement of the vaginal pressure profile using an optical-fiber-based instrumented speculum.
abstract: Pelvic organ prolapse (POP) occurs when changes to the pelvic organ support structures cause descent or herniation of the pelvic organs into the vagina. Clinical evaluation of POP is a series of manual measurements known as the pelvic organ prolapse quantification (POP-Q) score. However, it fails to identify the mechanism causing POP and relies on the skills of the practitioner. We report on a modified vaginal speculum incorporating a double-helix fiber-Bragg grating structure for distributed pressure measurements along the length of the vagina and include preliminary data in an ovine model of prolapse. Vaginal pressure profiles were recorded at 10 Hz as the speculum was dilated incrementally up to 20 mm. At 10-mm dilation, nulliparous sheep showed higher mean pressures ( 102 ± 46 ?? mmHg ) than parous sheep ( 39 ± 23 ?? mmHg ) ( P = 0.02 ), attributable largely to the proximal (cervical) end of the vagina. In addition to overall pressure variations, we observed a difference in the distribution of pressure that related to POP-Q measurements adapted for the ovine anatomy, showing increased tissue laxity in the upper anterior vagina for parous ewes. We demonstrate the utility of the fiber-optic instrumented speculum for rapid distributed measurement of vaginal support.
authors.affiliation: Flinders University, Medical Device Research Institute, 1284 South Road, Tonsley, SA 5042, Australia.
authors.forename: Luke A
authors.initials: LA
authors.lastname: Parkinson
authors.affiliation: Hudson Institute of Medical Research, The Ritchie Centre, 27-31 Wright Street, Clayton, VIC 3168, AustraliacMonash University, Department of Obstetrics and Gynaecology, 246 Clayton Road, Clayton, VIC 3168, Australia.
authors.forename: Caroline E
authors.initials: CE
authors.lastname: Gargett
authors.affiliation: Hudson Institute of Medical Research, The Ritchie Centre, 27-31 Wright Street, Clayton, VIC 3168, Australia.
authors.forename: Natharnia
authors.initials: N
authors.lastname: Young
authors.affiliation: Hudson Institute of Medical Research, The Ritchie Centre, 27-31 Wright Street, Clayton, VIC 3168, AustraliacMonash University, Department of Obstetrics and Gynaecology, 246 Clayton Road, Clayton, VIC 3168, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Rosamilia
authors.affiliation: CSIRO Manufacturing, Research Way, Clayton, VIC 3168, Australia.
authors.forename: Aditya V
authors.initials: AV
authors.lastname: Vashi
authors.affiliation: Monash University, Department of Obstetrics and Gynaecology, 246 Clayton Road, Clayton, VIC 3168, AustraliadCSIRO Manufacturing, Research Way, Clayton, VIC 3168, Australia.
authors.forename: Jerome A
authors.initials: JA
authors.lastname: Werkmeister
authors.affiliation: Flinders University, Medical Device Research Institute, 1284 South Road, Tonsley, SA 5042, Australia.
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Papageorgiou
authors.affiliation: Flinders University, Medical Device Research Institute, 1284 South Road, Tonsley, SA 5042, Australia.
authors.forename: John W
authors.initials: JW
authors.lastname: Arkwright
mesh_terms: D000818:Animals; D001696:Biomechanical Phenomena; D005260:Female; D005336:Fiber Optic Technology / Q000295:instrumentation* / Q000379:methods*; D056887:Pelvic Organ Prolapse / Q000000981:diagnostic imaging; D011312:Pressure; D012756:Sheep; D013525:Surgical Instruments; D014621:Vagina / Q000000981:diagnostic imaging*