Pelvic Prolapse Model

1
Pelvic Prolapse Model

• BSAC-Andrew Bertram
• Communicator-Graham Bousley
• Team Leader-Hallie Kreitlow
• BWIG-Sarah Switalski
• Advisor Paul Thompson
• Client Dr. Tova Ablove

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Overview

• Pelvic organ prolapse background
• Problem statement
• Design specifications
• Current designs
• Design alternatives
• Design matrix
• Future work

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Pelvic Prolapse Background

• Pelvic Prolapse
• Pelvic floor muscles become weak and cannot
  support pelvic organs
• Causes
• Pregnancy
• Fifty percent
• Aging
• 50 years
• Obesity

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Pelvic Organ Prolapse Quantification Exam (POP-Q)

• Site specific staging system
• Stages
• Central vs.
• lateral
• Different types
• of prolapse
• Cystocele
• Rectocele
• Uterine
• Vault

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Problem Statement

• Design and fabricate a dynamic model to teach the
  pelvic organ prolapse quantification exam
  (POP-Q).

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Design Specifications

• Must contain bladder, uterus, rectum, vagina, and
  support systems
• Must simulate the different stages and central
  and lateral prolapse
• Dimensions to scale
• Easy to manipulate and reset
• Should not include labels (teaching model)
• Allotted budget 1,000

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Current Designs

• Static anatomical models
• Dynamic model
• Inverted Santa Claus hat
• Wooden frame
• Buttons

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Static Components of Designs

• External structure
• Pelvis
• Physical landmarks
• Urethra
• Rectum
• Vagina
• Colored segments for POP-Q measurement sites
• Silicone
• Anchoring system
• Diameter9cm
• Length30cm

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Weighted System
Cervix

• Drop objects down chutes in order to apply
  pressure to the walls of the vagina
• Disadvantages
• Upright Orientation
• Difficult to reset

Bladder
Rectum
Vagina
Side View Vertically Oriented
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Calibrated Pressure/Rod System

• Balloons
• Inflate with calibrated syringes
• One at each POP-Q measurement site
• Rods
• Cervix
• Lateral prolapse

Side View
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Rod System

• Rods control objects to press on anterior and
  posterior walls

Bladder
Cervix
Vagina
Rectum
Side View
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Design Matrix
Criteria Weight Rod System Weighted System Calibrated Pressure/Rod System
Feasibility 40 30 10 20
Accuracy 20 15 5 15
Ease of Use 20 15 5 20
Durability 15 15 10 5
Cost 5 5 3 2
Safety Y/N Y Y Y
Totals 100 80 33 62
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Future Work

• Test materials
• Finalize dimensions
• Assemble model
• Test and calibrate model

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References

• Beus, Tamara. Pelvic Organ Prolapse. Womens
  Health. 2003. Womens Health. www.womenshealthlond
  on.org.uk
• Flesh, MD, George. Pelvic Organ Prolapse
  Quantification System. UpToDate. May 2008. 10
  Sep. 2008. www.uptodate.com
• Geiss et. al. A simple teaching tool for
  training the pelvic organ prolapse quantification
  system. International Urogynecology Journal.
  2007. Volume 18 1003-1005
• Herschorn, MD, FRCSC, Sender. Female Pelvic
  Floor Anatomy The Pelvic Floor, Supporting
  Structures, and Pelvic Organs. MedReviews. 2004.
  18Sep 2008. www.pubmedcentral.nih.gov
• Bard. www.bardurological.com/POP-Q

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• Questions?

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Design- Calibrated Pressure/Rod System

• Pros
• More visually accurate
• Calibrated Pressure System
• Cons
• Less Durable
• Harder to scale up
• More expensive
• Harder to find materials

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Design- Weighted System

• Pros
• Not visually accurate
• More realistic measurements for POP-Q Exam
  (variability)
• Cons
• Difficult to calibrate
• Difficult to reset
• Not as durable
• Cannot simulate all types of prolapse

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Design- Rod System

• Pros
• Simpler to fabricate and use
• Cheaper
• Movements are easily controlled
• Easy to scale up