MR Defecography Improves Diagnosis of Postoperative Pelvic Floor Dysfunction After Gynecological Surgery

Pelvic floor dysfunction (PFD) is one of the most significant postoperative consequences in gynecological surgery, leading to impaired bowel function, structural alteration, and reduced quality of life. The conventional technique using fluoroscopic defecography and perineal ultrasonography provides an incomplete assessment of multi-compartment defects and post-surgical changes. Magnetic resonance defecography (MRD) represents a valuable alternative imaging method in the assessment of PFD following gynecological surgery, increasing diagnostic accuracy and enabling personalized treatment planning. MRD achieves high-resolution multi-compartmental assessment of the pelvic floor in dynamic states. Particularly, it is able to detect postoperative complications such as mesh retraction, organ prolapse, and fistula formation, not visible to other modalities. This narrative review discusses the role of MRD in diagnosing PFD and its advantages in detecting functional and anatomical changes following gynecological surgery. This review also examined the ability of MRD to demonstrate surgical changes and its contribution to possible standardization in clinical practice.