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

2.  Pelvic organ prolapse background  Problem statement  Design specifications  Current designs  Design alternatives  Design matrix  Future work

3.  Pelvic Prolapse ◦ Pelvic floor muscles become weak and cannot support pelvic organs  Causes ◦ Pregnancy  Fifty percent ◦ Aging  50+ years ◦ Obesity

4.  Site specific staging system  Stages  Central vs. lateral  Different types of prolapse: ◦ Cystocele ◦ Rectocele ◦ Uterine ◦ Vault

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

6.  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

7.  Static anatomical models  Dynamic model ◦ Inverted Santa Claus hat  Wooden frame  Buttons

8.  External structure ◦ Pelvis ◦ Physical landmarks  Urethra  Rectum  Vagina ◦ Colored segments for POP-Q measurement sites ◦ Silicone ◦ Anchoring system ◦ Diameter~9cm ◦ Length~30cm

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

10.  Balloons ◦ Inflate with calibrated syringes ◦ One at each POP-Q measurement site  Rods ◦ Cervix ◦ Lateral prolapse Side View

11.  Rods control objects to press on anterior and posterior walls Side View Bladder Rectum Vagina Cervix

12. CriteriaWeightRod SystemWeighted System Calibrated Pressure/Rod System Feasibility40301020 Accuracy20155 Ease of Use2015520 Durability15 105 Cost5532 SafetyY/NYYY Totals100803362

13.  Test materials  Finalize dimensions  Assemble model  Test and calibrate model

14.  Beus, Tamara. “Pelvic Organ Prolapse.” Women’s Health. 2003. Women’s Health. www.womenshealthlondon.org.uk www.womenshealthlondon.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 www.pubmedcentral.nih.gov  Bard. www.bardurological.com/POP-Q

15. Questions?

16.  Pros ◦ More visually accurate ◦ Calibrated Pressure System  Cons ◦ Less Durable ◦ Harder to scale up ◦ More expensive ◦ Harder to find materials

17.  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

18.  Pros ◦ Simpler to fabricate and use ◦ Cheaper ◦ Movements are easily controlled ◦ Easy to scale up