Erratum: Comparison of magnetic resonance defecography with pelvic floor ultrasound and vaginal inspection in the urogynecological diagnosis of pelvic floor dysfunction

Abstract Purpose to assess the role of the role of MR defecography in assessment of pelvic floor failure . Methods and Material Thirty-six patients (twenty-seven female and nine male) with female and male patients, complaining of stress urinary incontinence, constipation, fecal incontinence or pelvic organ prolapse. Results MRI revealed 18 cystocele (50%), compared to physical examination 2 cases(5.6%),MRI revealed 28 rectocele ( 77.8%) compared to physical examination that showed 13 (36.1%) , MRI revealed 10 uterine descent (40.7%), compared to physical examination 6 (22.2%) I, MRI revealed 7 enterocele (19.4%) compared to physical examination that was negative. MRI revealed level I/II facial defect in and level III facial defect in, 19 cases of Intussusception (52.8%), urethral hypermobility in 14 (38.9%), sphincteric defect 7 (19.4%), levator angle weakness in 30 cases (83.3%), iliococcygeaus muscle tear in 5 cases (13.9%), puborectalis tear in 3 cases (8.3%),anorectal decent in 26 cases (72.2%), genital hiatus width in 23 (63.9%) Conclusion Dynamic MR imaging is a necessary tool in the diagnosis of multicompartment pelvic organ prolapse and it provides good concordance with clinical examination

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Impact of pelvic floor ultrasound in diagnosis of postpartum pelvic floor dysfunction

Medicine ◽

10.1097/md.0000000000021582 ◽

2020 ◽

Vol 99 (32) ◽

pp. e21582

Author(s):

Fan-bo Wang ◽

Rong Rong ◽

Jing-jun Xu ◽

Guang Yang ◽

Tian-you Xin ◽

...

Keyword(s):

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Pelvic Floor Ultrasound

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Role of Magnetic Resonance Imaging in the Diagnosis and Management of Pelvic Floor Dysfunction

Journal of SAFOG with DVD ◽

10.5005/jp-journals-10006-1505 ◽

2017 ◽

Vol 9 (3) ◽

pp. 250-254

Author(s):

Poornima Shankar ◽

Shaanthy Gunasingh

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pelvic Floor ◽

Clinical Examination ◽

Pelvic Floor Dysfunction ◽

Resonance Imaging ◽

Levator Hiatus ◽

Pelvic Floor Exercises ◽

Mean Values

ABSTRACT Aim To study the effect of age and parity in pelvic floor anatomy in women with pelvic floor dysfunction and the changes in pelvic floor anatomy after a course of pelvic floor exercises. Design A prospective study at Government Kilpauk Medical College (KMC), Chennai. Materials and methods Patients with pelvic floor dysfunction are subjected to clinical examination and magnetic resonance imaging (MRI). The changes in anatomy are analyzed in terms of levator hiatus dimension and descent of the pelvic organs. Substratified analysis is done and mean diameters in each degree of prolapse are identified (Chi-square tests using cross tables). Patients with cystocele, rectocele, or enterocele are also compared in both clinical examination and MRI and the degree of correlation is measured (inter-rater kappa). The changes in pelvic floor anatomy in terms of H line, M line, and levator plate angle with respect to age and parity are studied. In patients with lower degrees of prolapse, the changes in anatomy in terms of H line, M line, and levator plate angle are studied after a course of pelvic floor exercises (post hoc tests and paired t-tests). The area under curve of receiver-operating curve in each degree of prolapse is seen and the critical cut-off value of the various anatomical parameters above which a patient develops a prolapse is calculated. Results Ninety patients with symptoms of pelvic floor dysfunction were studied with clinical examination and MRI. Levator hiatus width cut off at rest above 5 cm and at straining above 5.8 cm develops clinical first-degree prolapse. Levator plate angle of more than 44.4° develops a clinical first-degree prolapse. With increasing age there is an increase in mean values of levator hiatus width at straining, levator plate angle, and descent of various organs. With increasing parity, there is an increase in mean values of levator hiatus width at rest and straining and increase in descent at straining. Conclusion Magnetic resonance imaging should be considered as a pretreatment planning tool when the physical findings are equivocal. How to cite this article Shankar P, Gunasingh S. Role of Magnetic Resonance Imaging in the Diagnosis and Management of Pelvic Floor Dysfunction. J South Asian Feder Obst Gynae 2017;9(3):250-254.

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Role of Dynamic Magnetic Resonance Imaging in Assessment of Female Pelvic Floor Dysfunction

The Egyptian Journal of Hospital Medicine ◽

10.12816/0000838 ◽

2013 ◽

Vol 51 ◽

pp. 216-225

Author(s):

Aliaa S. Sheha ◽

Ola M. Nouh ◽

Inas M. Azab ◽

Mohamed A Nassef ◽

Ahmed M Ibrahim

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Dynamic Magnetic Resonance Imaging ◽

Resonance Imaging ◽

Female Pelvic Floor ◽

Dynamic Magnetic Resonance ◽

Female Pelvic Floor Dysfunction

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Comparative study of magnetic resonance defaecography and evacuation proctography in evaluation of pelvic floor dysfunction

http://isrctn.org/> ◽

10.1186/isrctn73466412 ◽

2013 ◽

Author(s):

Michael Feretis

Keyword(s):

Magnetic Resonance ◽

Comparative Study ◽

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Evacuation Proctography

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Focal levator ani eventrations: detection and characterization by magnetic resonance in patients with pelvic floor dysfunction

International Urogynecology Journal ◽

10.1007/s00192-003-1037-4 ◽

2003 ◽

Vol 14 (2) ◽

pp. 89-93 ◽

Cited By ~ 9

Author(s):

H. K. Pannu ◽

R. Genadry ◽

S. Gearhart ◽

H. S. Kaufman ◽

G. W. Cundiff ◽

...

Keyword(s):

Magnetic Resonance ◽

Pelvic Floor ◽

Pelvic Floor Dysfunction ◽

Levator Ani

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Role of MRI defecography in assessment of pelvic floor pathologies

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20193250 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1003

Author(s):

Suhail Rafiq ◽

Sheema Posh ◽

Fahad Shafi ◽

Sheikh Riyaz

Keyword(s):

Magnetic Resonance ◽

Pelvic Floor ◽

Real Time ◽

Temporal Resolution ◽

Common Finding ◽

Age Group ◽

Pelvic Floor Function ◽

Mr Defecography ◽

Magnetic Resonance Defecography ◽

Floor Function

Background: Functional disorders of the pelvic ﬂoor are a common clinical problem. Diagnosis and treatment of these disorders, which frequently manifest with nonspeciﬁc symptoms such as constipation or incontinence, remain difﬁcult. MR Defecography has emerged over the last decade as a modality which additionally images the pelvic floor function in real time besides combining the advantages of previously used modalities and that of magnetic resonance i.e. multiplanar imaging, good temporal resolution and lack of radiation exposure. Dynamic MRI defecography is a relatively new imaging protocol which can be extremely useful in identification of anatomic and functional pelvic floor dysfunction such as organ prolapse, anismus and fecal incontinence. Excellent demonstration of the perirectal soft tissues allows assessment of spastic pelvic ﬂoor syndrome and descending perineum syndrome and visualization of enteroceles. The aim of the study was to assess causes of pelvic floor dysfunction.Methods: Authors evaluated 25 patients with cine Magnetic Resonance Defecography at our center between December 2018 and 15th May 2019. MR Defecography was done with help of 3 Tesla Somatom Seimens MRI. Ultrasound jelly was instilled into the rectum of patient via a short flexible tube while the patient lies in the lateral decubitus position on the scanner table before being moved into the gantry and was asked to defecate when instructed. Scanning was done in four phases-resting, straining, squeezing and defecation as per the standard protocol while patient lied supine.Results: Most common complaint encountered was that of constipation. Patients in age group 20-70 years were studied. Maximum patient were of the age group 40-50 years. Most common finding was organ prolapse in total 9 patients with anterior rectocele in 6 patients followed by rectal prolapse.Conclusions: Magnetic resonance defecography is an excellent modality for assessment of pelvic floor disorders. It has very good temporal resolution and high soft tissue contrast, also allows visualization of the pelvic floor function in real-time without any radiation load. Imaging the defecation process in real-time leads to a definitive diagnosis in cases of dysfunctional defecation and a precise diagnostic and pre-operative assessment in cases of organ prolapse.

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