Can We Improve Vaginal Tissue Healing Using Customized Devices: 3D Printing and Biomechanical Changes in Vaginal Tissue

Gynecol Obstet Invest. 2019;84(2):145-153. doi: 10.1159/000491696. Epub 2018 Sep 28.

Abstract

Background: Determining biomechanical changes in vaginal tissue with tissue stretch is critical for understanding the role of mechanotransduction on vaginal tissue healing. Noncontact dynamic optical coherence elastography (OCE) can quantify biomechanical changes in vaginal tissues noninvasively. Improved vaginal tissue healing will reduce postoperative complications from vaginal surgery.

Aims: (1) To complete dimensional assessments (DAs) of the vaginal tract. (2) To elucidate biomechanical properties (BMP) of porcine vaginal tissues (PVT). (3) Compare BMPs of piglet and adult PVTs after placement of customized vaginal dilators (VD) by OCE and uniaxial mechanical testing (MT).

Methods: Pilot study using adult nulliparous pig and piglet PVTs (n = 20 each). DA of PVTs was performed using silicone molding. 3D-printed VDs were used to achieve different Relative Diameter Change (RDC) of the PVTs (no dilatation, and -50%, 0%, 50% RDC). Elastographic testing using OCE and MT.

Results: Using OCE, no significant differences (SD) were noted between adult and piglet PVT (p = 0.74) or by stretch direction (p = 0.300). SD was noted with increasing RDC (p = 0.023). Using MT, there were SD in tissue stiffness between adult and piglet PVT (p = 0.048), but no SD as a function of RDC (p = 0.750) or stretch direction (p = 0.592).

Conclusions: This study quantified biomechanical changes in PVT with customized stretching by 3D printed VD using both OCE and MT. This work has implications for the mechanotransduction of vaginal wound healing and noninvasive assessment of vaginal diseases.

Keywords: 3D printing; Optical coherence elastography; Porcine vagina; Tissue healing; Vaginal dilator; Young’s modulus.

MeSH terms

  • Animals
  • Biomechanical Phenomena
  • Cicatrix / physiopathology
  • Elasticity Imaging Techniques / methods
  • Female
  • Mechanotransduction, Cellular
  • Pilot Projects
  • Printing, Three-Dimensional*
  • Sus scrofa
  • Tomography, Optical Coherence
  • Vagina / pathology
  • Vagina / physiopathology*
  • Vaginal Diseases / pathology
  • Vaginal Diseases / physiopathology*
  • Wound Healing / physiology*