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Updated: Jan 13, 2026
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Quantification of Levator Ani Hiatus Enlargement by Magnetic Resonance Imaging in Males and Females with Pelvic Organ Prolapse
Published on: April 17, 2019
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Assessing Pelvic Organ Prolapse Volume in Patients with Rectal Prolapse via MRI
Shayan Khorsandi1,2, Vipul R Sheth3, Audrey Chow4
1Urogynecology, Stanford University Hospital, Stanford, CA, USA. shayan.drk@gmail.com.
International Urogynecology Journal
|October 28, 2025
Summary
Magnetic resonance imaging (MRI) defecography accurately measures pelvic organ prolapse (POP) volume in rectal prolapse (RP) patients. Straining measurements (eLASV-S) effectively identify severe POP, guiding surgical decisions.
Area of Science:
- Pelvic floor disorders
- Medical imaging
- Gastroenterology
Background:
- Pelvic organ prolapse (POP) severity assessment is crucial, especially in rectal prolapse (RP) patients.
- The role of MRI in quantifying POP in RP patients is not well understood.
- Accurate POP volume measurement may aid in targeted interventions.
Purpose of the Study:
- To investigate the utility of MRI defecography in assessing POP volume in patients with RP.
- To determine if MRI-derived volume measurements can improve screening for symptomatic POP.
- To assess if POP volume measurements can guide clinical interventions in RP patients.
Main Methods:
- Retrospective cohort study of 77 women with RP undergoing MRI defecography.
- Calculation of estimated levator ani subtended volume (eLASV) at rest (eLASV-R) and during strain (eLASV-S).
- Multivariable regression and Youden's index used to identify significant volume cutoffs.
Main Results:
- eLASV-S measurements were predictive of symptomatic POP.
- An eLASV-S cutoff of 102.5 cm³ was significantly associated with the need for surgery.
- eLASV-S demonstrated superior differentiation between symptomatic and asymptomatic POP compared to eLASV-R.
Conclusions:
- MRI defecography, specifically eLASV-S, is valuable for identifying high-volume POP in RP patients.
- A significant eLASV-S cutoff aids in clinical decision-making for POP management.
- Further prospective studies are recommended to validate MRI's diagnostic potential in POP.
Keywords:
MR defecographyPelvic organ prolapse symptom predictabilityPelvic organ prolapse volumeRectal prolapseeLASVMore Related Videos
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