Pelvic floor failure: MR imaging evaluation of anatomic and functional abnormalities

Area of Science:

• Women's Health
• Medical Imaging
• Pelvic Floor Disorders

Background:

• Pelvic floor failure is a common condition affecting women, leading to urinary/fecal incontinence, defecation difficulties, and pain.
• Risk factors include altered collagen metabolism, vaginal delivery, menopause, and advanced age.
• It involves complex fascial and muscular lesions, potentially causing pelvic organ prolapse.

Purpose of the Study:

• To present high-resolution MR imaging techniques for detailed assessment of pelvic floor failure.
• To correlate imaging findings with pathophysiology, symptoms, and dysfunction patterns.
• To emphasize MR imaging's role in improving surgical outcomes and reducing relapse rates.

Main Methods:

• Utilizing a two-step MR imaging process: static axial fast spin-echo (FSE) T2-weighted images for anatomic damage and dynamic sagittal single-shot T2-weighted sequences for functional evaluation during straining.
• High-resolution FSE T2-weighted images were used for detailed lesion assessment.
• Dynamic sequences captured functional abnormalities during defecation simulation.

Main Results:

• High-resolution MR imaging allows for detailed assessment of various anatomic lesions in pelvic floor failure.
• Dynamic MR sequences reveal patterns of pelvic floor dysfunction.
• The study demonstrates MR imaging's capability to comprehensively evaluate both anatomic and functional pelvic abnormalities.

Conclusions:

• MR imaging is a powerful tool for preoperative assessment of pelvic floor failure.
• Accurate diagnosis aids surgeons in selecting appropriate treatments.
• Comprehensive evaluation can help reduce the significant 30% relapse rate associated with pelvic floor disorders.