Experimental investigation of the biomechanics of urethral tissues and structures.
Abstract: What is the central question of this study? Prostheses for treatment of urinary incontinence elicit complications associated with an inadequate mechanical action. This investigation aimed to define a procedure addressed to urethral mechanical characterization. Experimental tests are the basis for constitutive formulation, with a view to numerical modelling for investigation of the interaction between the tissues and a prosthesis. What is the main finding and its importance? Horse urethra, selected for its histomorphometric similarity to human urethra, was characterized by integrated histological analysis and mechanical tests on the biological tissue and structure, leading to constitutive formulation. A non-linear, anisotropic and time-dependent response was found, representing a valid basis for development of a numerical model to interpret the functional behaviour of the urethra. Urinary dysfunction can lead to incontinence, with an impact on the quality of life. Severe dysfunction can be overcome surgically by the use of an artificial urinary sphincter. Nonetheless, several complications may result from inappropriate functioning of the prosthesis, in many instances resulting from an unsuitable mechanical action of the device on the urethral tissues. Computational models allow investigation of the mechanical interaction between biological tissues and biomedical devices, representing a potential support for surgical practice and prosthesis design. The development of such computational tools requires experimental data on the mechanics of biological tissues and structures, which are rarely reported in the literature. The aim of this study was to provide a procedure for the mechanical characterization of urethral tissues and structures. The experimental protocol included the morphometric and histological analysis of urethral tissues, the mechanical characterization of the response of tissues to tensile and stress-relaxation tests and evaluation of the behaviour of urethral structures by inflation tests. Results from the preliminary experiments were processed, adopting specific model formulations, and also providing the definition of parameters that characterize the elastic and viscous behaviour of the tissues. Different experimental protocols, leading to a comprehensive set of experimental data, allow for a reciprocal assessment of reliability of the investigation approach.
© 2016 The Authors. Experimental Physiology © 2016 The Physiological Society.
Publication Date: 2016-03-24 PubMed ID: 26864993DOI: 10.1113/EP085476Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research aimed to identify the mechanical characteristics of urethral tissues and structures using experimental methods, in order to improve prosthesis design and treatment for urinary incontinence. The study relied on histological analysis and mechanical testing to gain insights that can support numerical modelling of the biological tissue’s functionality.
Research Background and Objectives
- This study is based on the ongoing challenges encountered with prosthetic treatments for urinary incontinence, where potential complications arise due to inadequate mechanical action.
- The central goal of the research was to understand the nuanced characteristics of the urethral structure from a mechanical perspective, and use this knowledge to enhance the design and functionality of prosthetic devices in treating urinary incontinence.
Methodology
- The researchers used horse urethra for the experimental tests due its histomorphometric similarity to that of a human.
- They integrated histological analysis with mechanical tests on this biological tissue and structure to define a constitutive formulation. The process included conducting morphometric and histological analyses of homogenous urethral tissues, applying tensile and stress relaxation tests, and evaluating the behaviour of urethral structures through inflation tests.
Key Findings
- The study found that the urethra exhibits a non-linear, anisotropic and time-dependent response, which provides an accurate foundation for developing numerical models for understanding the functional behaviour of the urethra.
- This finding has significant value because numerical models can simulate the mechanical interaction between biological tissues and medical implants, serving as a resourceful tool for improving surgical procedures and prosthetic designs.
Implications of the Research
- A comprehensive understanding of the mechanics of urethral tissues could lead to better predictions of how these tissues would respond to an artificial urinary sphincter, thus improving outcomes and reducing complication rates.
- These findings would also inform accurate constitutive models, facilitating more efficient design of biomedical devices for urological and surgical applications.
Limitations and Future Work
- The scarcity of available experimental data on the mechanics of biological tissues and structures points to one limitation of the current study. This paucity of data may reduce the accessibility and general applicability of the research.
- Considering its potential value in surgical practice and prosthetic design, future research can leverage these results for further numerical modelling and experimental validation, towards more sophisticated and personalized treatments for urinary dysfunction and incontinence.
Cite This Article
APA
Natali AN, Carniel EL, Frigo A, Pavan PG, Todros S, Pachera P, Fontanella CG, Rubini A, Cavicchioli L, Avital Y, De Benedictis GM.
(2016).
Experimental investigation of the biomechanics of urethral tissues and structures.
Exp Physiol, 101(5), 641-656.
https://doi.org/10.1113/EP085476 Publication
Researcher Affiliations
- Department of Industrial Engineering, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Industrial Engineering, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Industrial Engineering, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Industrial Engineering, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Industrial Engineering, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Industrial Engineering, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Biomedical Sciences, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Biomedical Sciences, University of Padova, Italy.
- Department of Comparative Biomedicine and Food Science, University of Padova, Italy.
- Department of Animal Medicine, Production and Health, University of Padova, Italy.
- Centre for Mechanics of Biological Materials, University of Padova, Italy.
- Department of Animal Medicine, Production and Health, University of Padova, Italy.
MeSH Terms
- Animals
- Biomechanical Phenomena / physiology
- Computer Simulation
- Horses
- Male
- Quality of Life
- Reproducibility of Results
- Stress, Mechanical
- Tensile Strength / physiology
- Urethra / anatomy & histology
- Urethra / physiology
Citations
This article has been cited 14 times.- Fontanella CG, Carniel EL. Biomechanics of Hollow Organs: Experimental Testing and Computational Modeling. Bioengineering (Basel) 2023 Jan 29;10(2).
- Jaskowak D, Nunez R, Ramachandran R, Alhajjar E, Yin J, Guidoboni G, Danziger ZC. Mathematical modeling of the lower urinary tract: A review. Neurourol Urodyn 2022 Aug;41(6):1305-1315.
- Fontanella CG, Carniel EL, Corain L, Peruffo A, Iacopetti I, Pavan PG, Todros S, Perazzi A. Mechanical behaviour of healthy versus alkali-lesioned corneas by a porcine organ culture model. BMC Vet Res 2021 Oct 28;17(1):340.
- Serpilli M, Zitti G, Dellabella M, Castellani D, Maranesi E, Morettini M, Lenci S, Burattini L. A Preliminary Validation of a New Surgical Procedure for the Treatment of Primary Bladder Neck Obstruction Using a Computational Modeling Approach. Bioengineering (Basel) 2021 Jun 22;8(7).
- Routzong MR, Martin LC, Rostaminia G, Abramowitch S. Urethral support in female urinary continence part 2: a computational, biomechanical analysis of Valsalva. Int Urogynecol J 2022 Mar;33(3):551-561.
- Cunnane EM, Davis NF, Cunnane CV, Lorentz KL, Ryan AJ, Hess J, Weinbaum JS, Walsh MT, O'Brien FJ, Vorp DA. Mechanical, compositional and morphological characterisation of the human male urethra for the development of a biomimetic tissue engineered urethral scaffold. Biomaterials 2021 Feb;269:120651.
- Mackiewicz AG, Klekiel T, Kurowiak J, Piasecki T, Bedzinski R. Determination of Stent Load Conditions in New Zealand White Rabbit Urethra. J Funct Biomater 2020 Sep 25;11(4).
- Salmaso C, Toniolo I, Fontanella CG, Da Roit P, Albanese A, Polese L, Stefanini C, Foletto M, Carniel EL. Computational Tools for the Reliability Assessment and the Engineering Design of Procedures and Devices in Bariatric Surgery. Ann Biomed Eng 2020 Oct;48(10):2466-2483.
- Shokri P, Mohsen Ziaee SA, Borumandnia N, Tabatabaei S. Experimental evaluation of the optimum applied pressure and number of cuffs for artificial sphincter in fluid flow control in an ex vivo model. Asian J Urol 2025 Jul;12(3):402-406.
- Foster C, Tran R, Grover K, Salama A, Rowe CK. Development of an Ex Vivo Platform to Model Urethral Healing. Methods Protoc 2025 Aug 15;8(4).
- De Menech Q, Osorio Salazar A, Bourgogne Q, Civet Y, Baldit A, Perriard Y. Mechanical characterization and constitutive law of porcine urethral tissues: a hyperelastic fiber model based on a physical approach. Biomech Model Mechanobiol 2025 Jun;24(3):1031-1042.
- Mazzucco G, Pirini P, Fontanella CG, Berardo A, Mascolini MV, Toniolo I, Marziale L, Mazzocchi T, Lucarini G, Spiezia N, Carniel EL. In silico tools for mechanical analysis of extra- and intra-luminal artificial urinary sphincters. BJUI Compass 2025 Jan;6(1):e473.
- Skonieczna-Kurpiel J, Madej JP, Klekiel T, Mackiewicz A, Będziński R, Noszczyk-Nowak A, Piasecki T, Ceccopieri C. Histological and morphometrical evaluation of the urethral wall after bioresorbable stent implantation in male New Zealand White Rabbits: A preliminary study. Histol Histopathol 2024 Oct;39(10):1285-1294.
- Bhave A, Sittkus B, Urban G, Mescheder U, Möller K. Finite element analysis of the interaction between high-compliant balloon catheters and non-cylindrical vessel structures: towards tactile sensing balloon catheters. Biomech Model Mechanobiol 2023 Dec;22(6):2033-2061.
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