Skip to main content

Advertisement

SpringerLink
Log in

Dynamic magnetic resonance imaging evaluation before and after operation for pelvic organ prolapse

  • Pelvis
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to explore the value of dynamic magnetic resonance imaging (MRI) before and after operation for pelvic organ prolapse (POP).

Methods

Twenty-nine patients with POP (POP group) before and one month after surgery and 12 healthy women (control group) underwent static and dynamic MRI at rest and during straining (Valsalva maneuver). The preoperative MRI images of the POP and control groups were analyzed, and various measurements were recorded. Differences in measurements were compared between the POP and control groups; similarly, changes in measurements before and after operation were compared.

Results

In the POP group, MRI detected 29 anterior vaginal prolapses, 27 uterine prolapses, 1 rectoceles, and 14 pouch of Douglas hernias. In addition, 27 levator ani muscle defect and 15 pubocervical fascial defect cases were observed. The bladder-pubococcygeal line (B-PCL), uterus-pubococcygeal line (U-PCL), Douglas pouch-pubococcygeal line, the length of the hiatus, the descent of the levator plate, levator hiatus size, levator plate angle, iliococcygeus angle, and urethral inclination angle (UA) were larger in the POP group than in the control group. The pelvic organs’ positions returned to normal postoperatively in 9 of 21 cases. The B-PCL, U-PCL, and UA were smaller post-surgery than pre-surgery.

Conclusions

Static and dynamic MRI can comprehensively evaluate morphological and functional changes of the pelvic floor postoperatively.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

Data availability

The datasets used or analyzed during the current study are available from the corresponding author on reasonable request.

References

  1. Bradley CS (2018) Progress toward understanding pelvic organ prolapse. Am J Obstet Gynecol 218:267-268. doi: https://doi.org/10.1016/j.ajog.2018.01.042

    Article  PubMed  Google Scholar 

  2. Huang L, Zhao Z, Wen J, Ling W, Miao Y, Wu J (2020) Cellular senescence: A pathogenic mechanism of pelvic organ prolapse (Review). Mol Med Rep 22:2155-2162. doi: https://doi.org/10.3892/mmr.2020.11339

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Iglesia CB, Smithling KR (2017) Pelvic Organ Prolapse. Am Fam Physician 96:179-185

    PubMed  Google Scholar 

  4. Haylen BT, Maher CF, Barber MD, Camargo S, Dandolu V, Digesu A, Goldman HB, Huser M, Milani AL, Moran PA, Schaer GN, Withagen MI (2016) An International Urogynecological Association (IUGA) / International Continence Society (ICS) Joint Report on the Terminology for Female Pelvic Organ Prolapse (POP). Neurourol Urodyn 35:137-168. doi: https://doi.org/10.1002/nau.22922

    Article  PubMed  Google Scholar 

  5. Easley DC, Abramowitch SD, Moalli PA (2017) Female pelvic floor biomechanics: bridging the gap. Curr Opin Urol 27:262-267. doi: https://doi.org/10.1097/MOU.0000000000000380

    Article  PubMed  PubMed Central  Google Scholar 

  6. Pannu HK, Javitt MC, Glanc P, Bhosale PR, Harisinghani MG, Khati NJ, Mitchell DG, Nyberg DA, Pandharipande PV, Shipp TD, Siegel CL, Simpson L, Wall DJ, Wong-You-Cheong JJ (2015) ACR Appropriateness Criteria pelvic floor dysfunction. J Am Coll Radiol 12:134-142. doi: https://doi.org/10.1016/j.jacr.2014.10.021

    Article  PubMed  Google Scholar 

  7. Salvador JC, Coutinho MP, Venâncio JM, Viamonte B (2019) Dynamic magnetic resonance imaging of the female pelvic floor-a pictorial review. Insights Imaging 10:4. doi: https://doi.org/10.1186/s13244-019-0687-9

    Article  PubMed  PubMed Central  Google Scholar 

  8. El Sayed RF, Alt CD, Maccioni F, Meissnitzer M, Masselli G, Manganaro L, Vinci V, Weishaupt D; ESUR and ESGAR Pelvic Floor Working Group (2017) Magnetic resonance imaging of pelvic floor dysfunction - joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group. Eur Radiol 27:2067-2085. doi: https://doi.org/10.1007/s00330-016-4471-7

    Article  Google Scholar 

  9. Maccioni F, Al Ansari N, Buonocore V, Mazzamurro F, Indinnimeo M, Mongardini M, Catalano C (2016) Prospective Comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling. Eur Radiol 26:1783-1791. doi: https://doi.org/10.1007/s00330-015-4016-5

    Article  PubMed  Google Scholar 

  10. Kobi M, Flusberg M, Paroder V, Chernyak V (2018) Practical guide to dynamic pelvic floor MRI. J Magn Reson Imaging 47:1155-1170. doi: https://doi.org/10.1002/jmri.25998

    Article  PubMed  Google Scholar 

  11. Reiner CS, Weishaupt D (2013) Dynamic pelvic floor imaging: MRI techniques and imaging parameters. Abdom Imaging 38:903-911. doi: https://doi.org/10.1007/s00261-012-9857-7

    Article  PubMed  Google Scholar 

  12. El-Haieg DO, Madkour NM, Basha MAA, Ahmad RA, Sadek SM, Al-Molla RM, Tantwy EF, Almassry HN, Altaher KM, Mahmoud NEM, Aly SA (2019) Magnetic resonance imaging and 3-dimensional transperineal ultrasound evaluation of pelvic floor dysfunction in symptomatic women: a prospective comparative study. Ultrasonography 38:355-364. doi: https://doi.org/10.14366/usg.19007

    Article  PubMed  PubMed Central  Google Scholar 

  13. Hsu Y, Summers A, Hussain HK, Guire KE, Delancey JO (2006) Levator plate angle in women with pelvic organ prolapse compared to women with normal support using dynamic MR imaging. Am J Obstet Gynecol 194:1427-1433. doi: https://doi.org/10.1016/j.ajog.2006.01.055

    Article  PubMed  PubMed Central  Google Scholar 

  14. Ansquer Y, Fernandez P, Chapron C, Frey C, Bennis M, Roy C, Salomon L, Mandelbrot L, Carbonne B (2006) Static and dynamic MRI features of the levator ani and correlation with severity of genital prolapse. Acta Obstet Gynecol Scand 85:1468-1475. doi: https://doi.org/10.1080/00016340600984837

    Article  PubMed  Google Scholar 

  15. Li M, Wang B, Liu X, Qiao P, Jiao W, Jiang T (2020) MR defecography in the assessment of anatomic and functional abnormalities in stress urinary incontinence before and after pelvic reconstruction. Eur J Radiol 126:108935. doi: https://doi.org/10.1016/j.ejrad.2020.108935

    Article  PubMed  Google Scholar 

  16. Krofta L, Havelková L, Urbánková I, Krčmář M, Hynčík L, Feyereisl J (2017) Finite element model focused on stress distribution in the levator ani muscle during vaginal delivery. Int Urogynecol J 28:275-284. doi: https://doi.org/10.1007/s00192-016-3126-1

    Article  PubMed  Google Scholar 

  17. Lamblin G, Delorme E, Cosson M, Rubod C (2016) Cystocele and functional anatomy of the pelvic floor: review and update of the various theories. Int Urogynecol J 27:1297-1305. doi: https://doi.org/10.1007/s00192-015-2832-4

    Article  PubMed  Google Scholar 

  18. Li JR, Lei L, Luo N, Chen N, Xu HT, Xin Hu, Song Y, Wu Y (2021) Architecture of female urethral supporting structures based on undeformed high-resolution sectional anatomical images. Anat Sci Int 96:30-41. doi: https://doi.org/10.1007/s12565-020-00554-y

    Article  PubMed  Google Scholar 

  19. García del Salto L, de Miguel Criado J, Aguilera del Hoyo LF, Gutiérrez Velasco L, Fraga Rivas P, Manzano Paradela M, Díez Pérez de las Vacas MI, Marco Sanz AG, Fraile Moreno E (2014) MR imaging-based assessment of the female pelvic floor. Radiographics 34:1417-1439. doi: https://doi.org/10.1148/rg.345140137

    Article  PubMed  Google Scholar 

  20. Schmid FA, Gomolka RS, Hötker AM, Boss A, Kessler TM, Rossi C, Eberli D (2020) Evaluation of Urinary Sphincter Function by Rapid Magnetic Resonance Diffusion Tensor Imaging. Int Neurourol J 24:349-357. doi: https://doi.org/10.5213/inj.2040208.104

    Article  PubMed  PubMed Central  Google Scholar 

  21. Picchia S, Rengo M, Bellini D, Caruso D, Pironti E, Floris R, Laghi A (2019) Dynamic MR of the pelvic floor: Influence of alternative methods to draw the pubococcygeal line (PCL) on the grading of pelvic floor descent. Eur J Radiol Open 6:187-191. doi: https://doi.org/10.1016/j.ejro.2019.05.002

    Article  PubMed  PubMed Central  Google Scholar 

  22. Su D, Wen Y, Lin Q (2021) Particle Swarm Algorithm-Based Analysis of Pelvic Dynamic MRI Images in Female Stress Urinary Incontinence. Contrast Media Mol Imaging 2021:8233511. doi: https://doi.org/10.1155/2021/8233511

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Li N, Cui C, Cheng Y, Wu Y, Yin J, Shen W (2018) Association between Magnetic Resonance Imaging Findings of the Pelvic Floor and de novo Stress Urinary Incontinence after Vaginal Delivery. Korean J Radiol 19:715-723. doi: https://doi.org/10.3348/kjr.2018.19.4.715

    Article  PubMed  PubMed Central  Google Scholar 

  24. Handa VL, Roem J, Blomquist JL, Dietz HP, Muñoz A (2019) Pelvic organ prolapse as a function of levator ani avulsion, hiatus size, and strength. Am J Obstet Gynecol 221:41.e1-41.e7. doi: https://doi.org/10.1016/j.ajog.2019.03.004

    Article  Google Scholar 

  25. Kasturi S, Lowman JK, Kelvin FM, Akisik FM, Terry CL, Hale DS (2010) Pelvic magnetic resonance imaging for assessment of the efficacy of the Prolift system for pelvic organ prolapse. Am J Obstet Gynecol 203:504.e1-504.e5. doi: https://doi.org/10.1016/j.ajog.2010.06.034

    Article  Google Scholar 

  26. Mahfouz W, Elmissiry M, Gomaa SA, Koraitim A, Hassan H (2020) Evaluation of the effect of abdominal sacrocolpopexy (ASC) on urethral anatomy and continence mechanism using dynamic MRI. Int Urol Nephrol 52:1429-1435. doi: https://doi.org/10.1007/s11255-020-02444-8

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

None.

Funding

This research did not receive any funding.

Author information

Author notes

  1. Hongbo Zhang and Zeyan Wang are co-first authors and equally contributed to this work.

Authors and Affiliations

  1. Department of Radiology, The Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, China

    Hongbo Zhang, Jing Wang & Beibei Zhou

  2. Department of Radiology, Zhongshan City People’s Hospital, Zhongshan, China

    Zeyan Wang & Xuehong Xiao

Authors
  1. Hongbo Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Zeyan Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Xuehong Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jing Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Beibei Zhou
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

HZ participated in data collection, analysis, manuscript writing, and approval; ZW participated in project development, data collection, analysis, and approval; BZ participated in project development, data collection, analysis, manuscript writing and approval; XX participated in project development, data analysis; JW participated in analysis.

Corresponding author

Correspondence to Beibei Zhou.

Ethics declarations

Conflict of interest

The authors declare that they have no conflicts of interest regarding this research.

Ethical approval

This manuscript has not been published or presented elsewhere in part or in entirety and is not under consideration by another journal. All study participants provided informed consent, and the study design was approved by the appropriate ethics review board.

Consent to participate and consent to publish

Informed consent was obtained from all individual participants included in the study. The authors affirm that the participants provided informed consent for publication of the images in Figs. 1, 2, 3, 4, and 5.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, H., Wang, Z., Xiao, X. et al. Dynamic magnetic resonance imaging evaluation before and after operation for pelvic organ prolapse. Abdom Radiol 47, 848–857 (2022). https://doi.org/10.1007/s00261-021-03361-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-021-03361-9

Keywords

Search

Navigation