Detection of Age-Related Pelvic Floor Fragility in Female Patients Using Magnetic Resonance Imaging

As aging societies become increasingly widespread worldwide, the prevalence of pelvic floor (PF) disorders is also increasing, particularly among older women. We hypothesized that PF fragility associated with aging could be detected by examining its configurations and the condition of the levator ani muscle. Therefore, in the present study, we aimed to establish a method for detecting age-related PF fragilities by analyzing PF configuration and levator ani muscle thickness using magnetic resonance imaging (MRI).

In total, 328 healthy female participants aged 20-91 years were enrolled in this study. T2-weighted coronal MR images of the pelvis were used to classify PF configuration into four types: wing, shallow-V, deep-V, and cup. The correlation between age and levator ani muscle thickness was analyzed for each classification.

PF configuration was observed to transition from wing to shallow-V, deep-V, and finally to cup type with age. Additionally, a strong negative correlation was identified between age and levator ani muscle thickness (r = -0.75, P < 0.001). Levator ani muscle thickness decreased progressively in the following order: wing, shallow-V, deep-V, and cup.

This MRI-based visual classification method provides a simple and practical approach to evaluate age-related PF changes. Visually assessing PF configuration facilitates the detection of structural decline associated with aging.