Quantifying vaginal tissue elasticity under normal and prolapse conditions by tactile imaging

Abstract

Introduction and hypothesis: Vaginal tactile imaging (VTI) is based on principles similar to those of manual palpation. The objective of this study is to assess the clinical suitability of new approach for imaging and tissue elasticity quantification under normal and prolapse conditions.

Methods: The study subjects included 31 women with normal and prolapse conditions. The tissue elasticity (Young's modulus) was calculated from spatial gradients in the resulting 3-D tactile images.

Results: Average values for tissue elasticity for the anterior and posterior compartments for normal conditions were 7.4 ± 4.3 kPa and 6.2 ± 3.1 kPa respectively. For Stage III prolapse the average values for tissue elasticity for anterior and posterior compartments were 1.8 ± 0.7 kPa and 1.8 ± 0.5 kPa respectively.

Conclusions: VTI may serve as a means for 3-D imaging of the vagina and a quantitative assessment of vaginal tissue elasticity, providing important information for furthering our understanding of pelvic organ prolapse and surgical treatment.

Conflict of interest statement

Conflicts of interest None.

Figures

Fig. 1

The tactile sensor array mounted at the tip of the VTI probe allows recording the pressure patterns on the vaginal walls under manually applied pressure to compose 3-D tactile image of the vagina. a Vaginal examination with VTI probe; b view of the VTI

Fig. 2

Transverse and sagittal cross-sections of 3-D vaginal tactile image received with VTI for a patient with normal pelvic floor conditions (a) and stage III prolapse (b). Young’s modulus was calculated for areas specified by a rectangle

Fig. 3

Anterior tissue elasticity, Young’s modulus (E), vs anterior conditions defined by physical examination. a Apical anterior; b Mid-anterior

Fig. 4

Posterior tissue elasticity, Young’s modulus (E), vs posterior conditions defined by physical examination. a Apical posterior, b Mid-posterior

Fig. 5

Side wall tissue elasticity, Young’s modulus (E), vs conditions defined by physical examination. a Apical sides, b Mid sides

Fig. 6

Anterior/posterior spacing vs conditions defined by physical examination. a Apical vagina, b Mid-vagina