Dynamic magnetic resonance imaging; reliability of assessment and correlation with clinical findings of pelvic organ prolapse

IntroductionPelvic floor dysfunction and prolapse affect about 50% of women past middle age. Failure to recognize the complex set of pelvic floor defects in individuals leads to most postsurgical failures. Diagnosis and grading of pelvic floor dysfunction is primarily done by physical examination. Imaging does not have yet an established role in the investigation of prolapse, yet it is expected to play a role in preoperative planning identifying soft tissue abnormalities which will help avoiding recurrence.Aim of the workThis is a prospective study targeted at defining the role of MRI in assessment of pelvic floor prolapse in females.MethodsDynamic and static MRI was performed in 40 female patients complaining of pelvic organ prolapse and/or stress urinary incontinence or fecal incontinence. Full history was taken and clinical examination performed and findings compared with MRI results.ResultsGood concordance was found between dynamic MRI and clinical examination in all three compartments, it was 82.5% in the anterior compartment, 80% in the posterior compartment, 85% in enteroceles and 65.0% in the middle compartment.ConclusionDynamic MRI is expected to be a promising imaging tool and to play a larger role in the preoperative planning of pelvic organ prolapse in the near future.