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Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series

Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series
Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series
Background: penile clamps provide a means of preventing urinary incontinence in males following radical prostatectomy. In order for the devices to function, significant mechanical loads need to be applied to the penile tissues to close the urethra. However, such loads have the potential to cause damage to the vulnerable skin and underlying soft tissues. Accordingly, the study aimed to estimate the magnitudes of tissue deformations resulting from penile clamp application in three individual cases.

Methods: three individuals were recruited who currently use penile clamps to manage urinary incontinence following radical prostatectomy. Magnetic resonance images (MRI) of the penis were taken to produce a series of high contrast coronal and sagittal images both before and during the application of two commercially available clamps, modified for MRI compatibility. Tissue thickness measurements were estimated with the clamps in-situ and normalised to the unloaded baseline state.

Results: the estimated magnitude of tissue deformations resulting from clamp application ranged between 68-84%. There were minimal differences in these deformations between the clamp designs, both of which appeared effective in closing the urethra. Local stress concentrations were observed in the tissues, which were deformed around the shape of the clamp.

Conclusions: MRI enabled quantification of local tissue deformation during penile clamp application. The results revealed that clamps created large tissue deformations in all three cases, regardless of design. This information could inform the development of new clamp designs and materials to minimise the potential for tissue damage.

Level of evidence: 4
2051-4158
Lemmens, J
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Cohen, Peko
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Worsley, Peter
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Everitt, C
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Broadbridge, Jacqueline
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Gefen, Amit
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Rees, R.W.
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Drake, Marcus
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Macaulay, Margaret
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Fader, Miranda
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Bader, Daniel
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Lemmens, J
9631d4ae-1712-4f70-8e8f-abd72a29a846
Cohen, Peko
7da21eb6-dc9a-4f9d-a26e-dd57e8e3c30e
Worsley, Peter
6d33aee3-ef43-468d-aef6-86d190de6756
Everitt, C
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Broadbridge, Jacqueline
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Gefen, Amit
85d29654-5b34-472a-91ac-b2a31c590ea9
Rees, R.W.
83c573b8-8015-47bb-aba7-c06263f6f3f5
Drake, Marcus
a956bb01-b0d2-4806-ae04-f56c0ab1096a
Macaulay, Margaret
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Fader, Miranda
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Bader, Daniel
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Lemmens, J, Cohen, Peko, Worsley, Peter, Everitt, C, Broadbridge, Jacqueline, Gefen, Amit, Rees, R.W., Drake, Marcus, Macaulay, Margaret, Fader, Miranda and Bader, Daniel (2020) Magnetic resonance imaging to estimate tissue deformations during penile clamp application: a case series. Journal of Clinical Urology. (In Press)

Record type: Article

Abstract

Background: penile clamps provide a means of preventing urinary incontinence in males following radical prostatectomy. In order for the devices to function, significant mechanical loads need to be applied to the penile tissues to close the urethra. However, such loads have the potential to cause damage to the vulnerable skin and underlying soft tissues. Accordingly, the study aimed to estimate the magnitudes of tissue deformations resulting from penile clamp application in three individual cases.

Methods: three individuals were recruited who currently use penile clamps to manage urinary incontinence following radical prostatectomy. Magnetic resonance images (MRI) of the penis were taken to produce a series of high contrast coronal and sagittal images both before and during the application of two commercially available clamps, modified for MRI compatibility. Tissue thickness measurements were estimated with the clamps in-situ and normalised to the unloaded baseline state.

Results: the estimated magnitude of tissue deformations resulting from clamp application ranged between 68-84%. There were minimal differences in these deformations between the clamp designs, both of which appeared effective in closing the urethra. Local stress concentrations were observed in the tissues, which were deformed around the shape of the clamp.

Conclusions: MRI enabled quantification of local tissue deformation during penile clamp application. The results revealed that clamps created large tissue deformations in all three cases, regardless of design. This information could inform the development of new clamp designs and materials to minimise the potential for tissue damage.

Level of evidence: 4

Text
Magnetic Resonance Imaging to estimate Tissue deformations during penile clamp application A case series - Accepted Manuscript
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Accepted/In Press date: 22 March 2020

Identifiers

Local EPrints ID: 439001
URI: http://eprints.soton.ac.uk/id/eprint/439001
ISSN: 2051-4158
PURE UUID: 393385a3-8f5f-4d5d-9d34-16105e3f60be
ORCID for Peter Worsley: ORCID iD orcid.org/0000-0003-0145-5042
ORCID for Margaret Macaulay: ORCID iD orcid.org/0000-0003-1737-4589
ORCID for Daniel Bader: ORCID iD orcid.org/0000-0002-1208-3507

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Date deposited: 31 Mar 2020 16:31
Last modified: 07 Oct 2020 02:17

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Contributors

Author: J Lemmens
Author: Peko Cohen
Author: Peter Worsley ORCID iD
Author: C Everitt
Author: Amit Gefen
Author: R.W. Rees
Author: Marcus Drake
Author: Miranda Fader
Author: Daniel Bader ORCID iD

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