[Stress urinary incontinence in women: magnetic resonance assessment]

The preoperative radiologic study of female stress urinary incontinence is still incomplete and often not well tolerated. MRI is becoming a major diagnostic tool for pelvis assessment also thanks to its allowing dynamic studies. Therefore, MRI was used for the static and dynamic assessment of the pelvic floor, which is compromised in stress incontinence, in a series of 21 patients. Dynamic studies were reliable in all but two cases. Our MRI technique demonstrated anatomical and functional stress urinary incontinence alterations, such as the increased distance between urethra and pubic symphysis (16 patients), vaginal changes (7 patients), levator ani muscle changes (9 patients) and urethropelvic ligaments changes (9 patients). The functional changes caused by pelvic floor collapse were observed in all the patients with reliable dynamic studies, i.e., the posterior urethrovesical angle was increased and the pelvic floor excessively lowered during pelvic strain. Our preliminary results suggest that MRI can play a major role in the preoperative assessment of stress urinary incontinence, notwithstanding the fact that the exam is performed with the patient supine and therefore with no gravity.