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Imaging in Pelvic Organ Prolapse — When Should It Be Routine?

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Abstract

Purpose of Review

Imaging for pelvic organ prolapse (POP) has only been included in the guidelines for complex cases but with no clear definition for what is considered a complex case. We reviewed literature from the last 5 years describing the use of various imaging modalities in the diagnosis and evaluation of POP to explore emerging recommendations and better define when imaging should be considered in the evaluation of POP. We discuss each of the imaging modalities in terms of cost, availability, specifics on positioning during image capture, and their measurement parameters.

Recent Findings

Cystograms and defecography are not always reliable indicators of POP. Defecography results should be correlated with physical exam, since some women are diagnosed with rectocele on defecography, but do not have one clinically. MRI can potentially assist in selection of the appropriate surgical approach and may lead to improved long-term outcomes in POP surgery. Due to the availability and imaging quality of MRI and the known radiation exposure of CT scans, its use in the evaluation of POP is not widely considered first line. While there is wide utility of US for POP, the imaging is dependent on skilled operators and radiologist familiarity with the exam. Despite this, the lack of radiation, low cost, and availability make US a good candidate for the diagnosis of POP.

Summary

Incorporating imaging such as MRI or US in the diagnosis and management of POP may provide useful information in addition to pelvic exam in complex POP cases. There is still significant work to be done to create a more standardized approach that will allow radiologists and practitioners to confidently interpret the imaging studies to accurately assess the pelvic floor disorder and guide therapy.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Urology, University of Michigan, 1500 East Medical Center Drive, Taubman Center 3875, Ann Arbor, MI, 48109, USA

    Patricia Maymi-Castrodad

  2. West Virginia School of Osteopathic Medicine, Lewisburg, WV, USA

    Samuel Plaska

  3. Department of Urology, University of Michigan, Ann Arbor, MI, USA

    Priyanka Gupta

Authors
  1. Patricia Maymi-Castrodad
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  2. Samuel Plaska
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  3. Priyanka Gupta
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Correspondence to Patricia Maymi-Castrodad.

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Maymi-Castrodad, P., Plaska, S. & Gupta, P. Imaging in Pelvic Organ Prolapse — When Should It Be Routine?. Curr Bladder Dysfunct Rep 18, 269–273 (2023). https://doi.org/10.1007/s11884-023-00712-8

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