Pelvic Prolapse Model BSACAndrew Bertram CommunicatorGraham Bousley Team

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

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

Pelvic Prolapse Background � Pelvic Prolapse ◦ Pelvic floor muscles become weak and cannot support pelvic organs � Causes ◦ Pregnancy �Fifty percent ◦ Aging � 50+ years ◦ Obesity

Pelvic Organ Prolapse Quantification Exam (POP-Q) � Site specific staging system � Stages � Central vs. lateral � Different types of prolapse: ◦ ◦ Cystocele Rectocele Uterine Vault

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

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

Current Designs � Static anatomical models � Dynamic model ◦ Inverted Santa Claus hat �Wooden frame �Buttons

Static Components of Designs � External structure ◦ Pelvis ◦ Physical landmarks �Urethra �Rectum � Vagina ◦ ◦ ◦ Colored segments for POP-Q measurement sites Silicone Anchoring system Diameter~9 cm Length~30 cm

Weighted System Drop objects down chutes in order to apply pressure to the walls of the vagina Disadvantages Cervix Bladder Rectum ◦ Upright Orientation ◦ Difficult to reset Vagina Side View Vertically Oriented

Calibrated Pressure/Rod System Balloons ◦ Inflate with calibrated syringes ◦ One at each POP-Q measurement site Rods ◦ Cervix ◦ Lateral prolapse Side View

Rod System � Rods control objects to press on anterior and posterior walls Bladder Vagina Cervix Rectum Side View

Design Matrix 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 5 5 3 2 Safety Y/N Y Y Y Totals 100 80 33 62 Criteria Cost

Future Work � Test materials � Finalize dimensions � Assemble model � Test and calibrate model

References � Beus, Tamara. “Pelvic Organ Prolapse. ” Women’s Health. 2003. Women’s Health. www. womenshealthlondon. org. uk � Flesh, MD, George. “Pelvic Organ Prolapse Quantification System. ” Up. To. Date. 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. ” Med. Reviews. 2004. 18 Sep 2008. www. pubmedcentral. nih. gov � Bard. www. bardurological. com/POP-Q

Questions?

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

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

Design- Rod System � Pros ◦ ◦ Simpler to fabricate and use Cheaper Movements are easily controlled Easy to scale up