The purpose of this study is to investigate the feasibility and performance of a stationary, non-focused dual-sectored tubular transurethral ultrasound applicator for thermal exposure of tissue regions adjacent to the urethra for treatment of stress urinary incontinence (SUI) through acoustic and biothermal simulations on 3D anatomical models. Parametric studies in a generalized tissue model over dual-sectored ultrasound applicator configurations (acoustic surface intensities, lateral active acoustic output sector angles, and durations) were performed. Selected configurations and delivery strategies were applied on 3D pelvic anatomical models. Temperature and thermal dose distributions on the target region and surrounding tissues were calculated. Endovaginal cooling was explored as a strategy to mitigate vaginal heating. The 75-90° dual-sectored transurethral tubular transducer (3.5 mm outer diameter (OD), 14 mm length, 6.5 MHz, 8.8-10.2 W/cm2) and 2-3-min sonication duration were selected from the parametric study for acoustic and biothermal simulations on anatomical models. The transurethral applicator with two opposing 75-90° active lateral tubular sectors can create two heated volumes for a total of up to 1.8 cm3 over 60 EM43 °C, with at least 10 mm radial penetration depth, 1.2 mm urethral sparing, and no lethal damage to the vagina and adjacent bone (< 60 EM43 °C). Endovaginal cooling can be applied to further reduce the vaginal wall exposure (< 15 EM43 °C). Simulations on 3D anatomical models indicate that dual-sectored transurethral ultrasound applicators can selectively heat pelvic floor tissue lateral to the mid-urethra in short treatment durations, without damaging adjacent vaginal and bone tissues, as a potential alternative treatment option for stress urinary incontinence. Graphical abstract Schema for in silico investigation of transurethral ultrasound thermal therapy applicator for minimally invasive treatment of SUI.

中文翻译：

---

双扇区经尿道超声治疗压力性尿失禁：3D解剖模型的计算机模拟研究。

这项研究的目的是通过声学和生物热模拟研究固定式，非聚焦双扇区管状经尿道超声敷贴器对与尿道相邻的组织区域进行热暴露以治疗压力性尿失禁（SUI）的可行性和性能。在3D解剖模型上。在双扇区超声施加器配置（声学表面强度，横向活动声输出扇形角和持续时间）的广义组织模型中进行了参数研究。将选定的配置和递送策略应用于3D骨盆解剖模型。计算靶区域和周围组织上的温度和热剂量分布。探索将阴道冷却作为减轻阴道发热的策略。从声学参数研究中选择了75-90°双扇区经尿道管状换能器（3.5毫米外径（OD），14毫米长度，6.5 MHz，8.8-10.2 W / cm2）和2-3-min超声持续时间以及在解剖模型上进行生物热模拟。经尿道涂药器带有两个相对的75-90°的活动侧向管状扇形区域，可在60 EM43°C下产生两个加热的容积，总计高达1.8 cm3，径向穿透深度至少为10毫米，尿道保留为1.2毫米，且无致命作用损坏阴道和邻近骨骼（<60 EM43°C）。可以应用阴道内冷却来进一步减少阴道壁暴露（<15 EM43°C）。在3D解剖模型上的仿真表明，双扇区经尿道超声涂药器可以在较短的治疗时间内选择性地加热尿道中部外侧的骨盆底组织，而不会损坏相邻的阴道和骨组织，这是压力性尿失禁的潜在替代治疗选择。用于经微创治疗SUI的经尿道超声热疗敷料器的计算机调查的图形化抽象方案。