Anatomically based computational models of the male and female pelvic floor and anal canal.

Abstract

The understanding of the pelvic floor and anal canal, in the study of incontinence, has been limited by the inability to integrate both anatomy and physiology into a unified bioengineering model. However, this integration has been achieved in the study of other organs in the body, most notably the heart. In this study we construct three-dimensional anatomically realistic models of both the male and female pelvic floor and anal canal regions using similar techniques to those used in cardiac modelling. Anatomical data from the Visible Human Project was used to provide the anatomical positioning of each model component within the region of interest. A C1 continuous cubic Hermite finite element mesh was then created using an iterative linear fitting procedure (Root Mean Square (RMS) error of fit < 2 mm). With this mesh we seek to examine the roles of the various muscles in maintaining continence. Our ultimate aim is to provide a framework with which to examine the mechanics of normal function and stability in the pelvic floor, and the abnormalities associated with the defecation disorders fecal incontinence and obstructed defecation, thereby providing a tool to further the education of clinicians, patients, and students and enabling virtual planning of corrective surgery.