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The human pelvis has been reported to change in shape throughout adult lifetime, and also the expression of parturition scars, or "pelvic features", increases with age. However, little is known about the causes and timing of these changes. Here we investigate changes in pelvic shape and the expression of pelvic features by applying a comprehensive geometric morphometric approach to a modern sample of 167 adult individuals with known age, parity, and cause of death. Our results confirm that the pelvis changes in shape during adult life, but to a larger magnitude in females compared to males. Moreover, females showed three different phases of pelvic shape change, coinciding with the main period of reproduction (from 17 to about 37-40 years), the period after that but before menopause, and the postmenopausal period (after 50 years of age). Males exhibited two phases with relatively similar shape changes. The expression of parturition scars increased in females until about 40 years of age and stayed relatively constant thereafter. Only a very weak increase of feature expression was found in males. We hypothesize that changes of adult pelvic shape and feature expression result from a combination of hormone-mediated and mechanically induced bone remodeling. Estrogen-induced and pregnancy-related bone remodeling dominates in premenopausal women, whereas bone remodeling in response to mechanical factors may underlie pelvic shape changes in men and postmenopausal women. The continual widening of the birth canal during the reproductive period eases childbirth in a population, but it is unlikely that this remodeling pattern specifically evolved as an obstetric adaptation in the human lineage. The highly conserved endocrine system and estrogen-induced pelvic bone remodeling were already in place when the neonatal brain increased in the human lineage. But the regularity control of this conserved pathway may have been "fine-tuned" by selective forces in the human lineage.
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http://dx.doi.org/10.1127/anthranz/2021/1463 | DOI Listing |
Urogynecology (Phila)
December 2024
From the Division of Urogynecology and Reconstructive Pelvic Surgery, University of Alabama at Birmingham, Birmingham, AL.
Importance: Pelvic organ prolapse recurrence following native tissue repair occurs with composite failure rates of 9-19% within 12 months, predominantly involving apical/anterior compartments. Objective The objective of this study was to develop a novel vaginal orthosis (NVO) device prototype through an iterative design process based on investigator and user feedback.
Study Design: The NVO was designed based on pelvic floor biomechanical principles to mitigate unopposed intra-abdominal pressure of the anterior vagina by absorbing and redirecting intra-abdominal forces to the levator ani and tailored to accommodate postoperative vaginal caliber and axis.
J Biomech
December 2024
Centre for Orthopaedic Trauma and Research, Adelaide Medical School, University of Adelaide, Australia.
Biomechanical analysis is increasingly being undertaken in field-based settings, often using inertial sensors or video-based pose estimation. These advancements necessitate more practical and accessible scaling methods as alternatives to traditional laboratory-based techniques like optical marker-based scaling. LiDAR scanning is a technique that could provide a reliable and efficient means of scaling biomechanical models.
View Article and Find Full Text PDFTech Coloproctol
December 2024
Department of General Surgery, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey.
Background: Abdominoperineal resection (APR) is the standard treatment for locally advanced distal rectal cancer (LADRC) following neoadjuvant treatment when sphincter-preserving procedures are inapplicable. However, complications such as perineal site infection, perineal hernia and postoperative ileus remain ongoing challenges. We aimed to compare the rate of postoperative ileus due to pelvic incarceration in APR patients with/without pelvic inlet closure.
View Article and Find Full Text PDFNeurourol Urodyn
December 2024
Department of Urology, Bristol Urological Institute, Bristol, UK.
Introduction: Pelvic organ prolapse (POP) is a common condition, affecting women worldwide and is known to have a significant impact on Health Related Quality of Life (HRQoL). Although there are various treatment options available, including pelvic floor muscle training and support pessaries, many women opt for or require surgery, with a lifetime risk of needing surgery of 12%-19%. As with any operation, this does not come without its complications and the reoperation rate following POP surgery is up to 36%.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Orthopedics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jie Fang Avenue, Wuhan, 430030, People's Republic of China.
Purpose: The purposes of this study was to develop a novel therapy-oriented acetabular bone defects classification system based on Statistical shape models (SSMs) and evaluate the reliability and reproducibility of its application.
Methods: We retrospectively reviewed and annotated pelvic Computed tomography (CT) of patients who had undergone revision total hip arthroplasty at our institution and constructed a dataset to develop the novel method for quantitatively describing acetabular bone defects that is based on SSMs. Then, using this method, classification systems are suggestive for diagnosis and corresponding treatment suggestion.
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