Introduction And Hypothesis: The objective was to explore the association between urge urinary incontinence (UUI) and lax uterosacral ligaments (USL) using MRI.
Methods: Sixty-seven female participants were recruited prospectively: 41 continent volunteers (control group) and 26 patients with UUI. Static proton density- and T2-weighted turbo spin echo sequences of MR images were used.
The Pelvic Floor Disorders Consortium (PFDC) is a multidisciplinary organization of colorectal surgeons, urogynecologists, urologists, gynecologists, gastroenterologists, radiologists, physiotherapists, and other advanced care practitioners. Specialists from these fields are all dedicated to the diagnosis and management of patients with pelvic floor conditions, but they approach, evaluate, and treat such patients with their own unique perspectives given the differences in their respective training. The PFDC was formed to bridge gaps and enable collaboration between these specialties.
View Article and Find Full Text PDFObjective: Radiological findings in solitary rectal ulcer syndrome (SRUS) are well described for evacuation proctography (EP) but sparse for magnetic resonance defecography (MRD). In order to rectify this, we describe the spectrum of MRD findings in patients with histologically proven SRUS.
Materials And Methods: MRD from twenty-eight patients (18 female; 10 males) with histologically confirmed SRUS were identified.
Pelvic floor disorders are common and can negatively impact quality of life. Imaging of patients with pelvic floor disorders has been extremely heterogeneous between institutions due in part to variations in clinical expectations, technical considerations, and radiologist experience. In order to assess variations in utilization and technique of pelvic floor imaging across practices, the society of abdominal radiology (SAR) disease-focused panel on pelvic floor dysfunction developed and administered an online survey to radiologists including the SAR membership.
View Article and Find Full Text PDFReporting MR imaging of pelvic floor dysfunction can be made easy if radiologists understand the aim of each MR sequence and what to report in each set of MR images. For an MR imaging report that is critical in decision making for patient management, it is of paramount importance to the radiologist to know what to look for and where to look for it. This article presents a new term, integrated MR analytical approach.
View Article and Find Full Text PDFThis article reviews different approaches for describing pelvic floor anatomy; "Classic 3-Compartment Approach", "Active and Passive Conceptual Approach" and "Multilayered System Approach". However, these approaches cannot explain pathogenesis of various dysfunctions. "Functional 3-Part Pelvic Supporting Systems Approach" a new, more function-based classification of the pelvic floor support system is introduced in which all structures that contribute to same function are grouped under 1 system.
View Article and Find Full Text PDFThe pelvic floor is composed of a network of muscles, ligaments, and fasciae, which provide active and passive support for the pelvic organs. Impairment of these pelvic floor elements can result in a variety of functional abnormalities and single or multicompartment organ prolapse. Knowledge of normal pelvic floor anatomy can aid the radiologist in understanding the complex nature of pelvic floor dysfunction and is important for comprehensive image interpretation.
View Article and Find Full Text PDFPurpose: To develop recommendations for magnetic resonance (MR) defecography technique based on consensus of expert radiologists on the disease-focused panel of the Society of Abdominal Radiology (SAR).
Methods: An extensive questionnaire was sent to a group of 20 experts from the disease-focused panel of the SAR. The questionnaire encompassed details of technique and MRI protocol used for evaluating pelvic floor disorders.
Functional defecation disorders (FDD) encompass causes of constipation associated with anorectal dysfunction, which include dyssynergia or inadequate defecatory propulsion. FDD are frequently encountered in clinical practice and may affect up to 33-50% of patients with chronic constipation. The etiology of FDD is unclear, however, it has been defined as an acquired, but subliminal behavioral disorder.
View Article and Find Full Text PDFObjective: To develop recommendations that can be used as guidance for standardized approach regarding indications, patient preparation, sequences acquisition, interpretation and reporting of magnetic resonance imaging (MRI) for diagnosis and grading of pelvic floor dysfunction (PFD).
Methods: The technique included critical literature between 1993 and 2013 and expert consensus about MRI protocols by the pelvic floor-imaging working group of the European Society of Urogenital Radiology (ESUR) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) from one Egyptian and seven European institutions. Data collection and analysis were achieved in 5 consecutive steps.
Objective: The purpose of this commentary is to highlight several aspects of two main perspectives on sacrocolpopexy: surgical-which includes selection of a route for reconstructive surgery, types of surgical meshes available, advantages and disadvantages of each type of mesh, and the associated postoperative complication-and radiologic, that is, the role of imaging in improving outcome.
Conclusion: As new modalities and techniques related to sacrocolpopexy are developed, concepts of form and function change. With advances in imaging modalities, especially MRI and CT, and the postprocessing options available, the radiologist's role should extend beyond reporting imaging findings to sharing in the choice of the initial treatment plan.
Purpose: To prospectively analyze static and dynamic magnetic resonance (MR) images simultaneously to determine whether stress urinary incontinence (SUI), pelvic organ prolapse (POP), and anal incontinence are associated with specific pelvic floor abnormalities.
Materials And Methods: This study had institutional review board approval, and informed consent was obtained from all participants. There were 59 women: 15 nulliparous study control women (mean age, 25.
Objective: There has been no uniformity of opinion concerning the structures supporting the female urethra. Therefore, the aims of this prospective study were to define precisely the female urethral support structures at cadaveric anatomic dissection and histologic examination and to determine which of these structures can be detected on MRI of cadaveric specimens and of healthy volunteers.
Subjects And Methods: Dissection of seven formalin-preserved cadavers (age at death, 25-50 years; no parity history available) was performed by a professor of anatomy to explore the anatomy of the urethral supporting ligaments and was followed by MRI of the cadaveric specimens with ligamentous markers in place and then by histologic analysis of the dissected ligaments.