Dynamic magnetic resonance imaging evaluation before and after operation for pelvic organ prolapse.

Abstract

This study aimed to explore the value of dynamic magnetic resonance imaging (MRI) before and after operation for pelvic organ prolapse (POP). Twenty-nine patients with POP (POP group) before and one month after surgery and 12 healthy women (control group) underwent static and dynamic MRI at rest and during straining (Valsalva maneuver). The preoperative MRI images of the POP and control groups were analyzed, and various measurements were recorded. Differences in measurements were compared between the POP and control groups; similarly, changes in measurements before and after operation were compared. In the POP group, MRI detected 29 anterior vaginal prolapses, 27 uterine prolapses, 1 rectoceles, and 14 pouch of Douglas hernias. In addition, 27 levator ani muscle defect and 15 pubocervical fascial defect cases were observed. The bladder-pubococcygeal line (B-PCL), uterus-pubococcygeal line (U-PCL), Douglas pouch-pubococcygeal line, the length of the hiatus, the descent of the levator plate, levator hiatus size, levator plate angle, iliococcygeus angle, and urethral inclination angle (UA) were larger in the POP group than in the control group. The pelvic organs' positions returned to normal postoperatively in 9 of 21 cases. The B-PCL, U-PCL, and UA were smaller post-surgery than pre-surgery. Static and dynamic MRI can comprehensively evaluate morphological and functional changes of the pelvic floor postoperatively.