Related Experiment Video
Updated: Jun 12, 2026
Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
Do repetitive Valsalva maneuvers change maximum prolapse on dynamic MRI?
Julie A Tumbarello1, Yvonne Hsu, Christina Lewicky-Gaupp
1Pelvic Floor Research Group, University of Michigan, Ann Arbor, MI, USA. jtumbare@umich.edu
Introduction And Hypothesis:
This study seeks to quantify differences in anterior vaginal wall prolapse during sequential Valsalva attempts on dynamic magnetic resonance imaging (MRI).
Methods:
Subjects were taken from an on-going case-control study evaluating anterior vaginal wall prolapse. Women with a prolapse whose leading edge extended >or=1 cm beyond the hymenal ring were included (n = 40). All subjects performed three maximal Valsalva efforts while mid-sagittal dynamic MRI scans were obtained. Bladder descent between the first, second, and third maximal Valsalva efforts were compared.
Results:
Forty percent of women had a greater than 2-cm increase in prolapse size from their first to third Valsalva attempt. Ninety-five percent of women extended their prolapse further with a third Valsalva.
Conclusions:
As is true during clinical examination, several attempts may be required to have maximal anterior compartment prolapse present during dynamic MRI of the pelvic floor.
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