Vaginal shape at resting pelvic MRI: predictor of pelvic floor weakness?

Objective: The objective was to determine if alteration in vaginal shape seen on nonstraining pelvic magnetic resonance (MR) scans is associated with pelvic floor weakness.

Methods: Two readers classified the shape of the middle third of the vagina on resting T2-weighted axial images as normal or abnormal for 76 women with and without pelvic floor weakness.

Results: The sensitivity and specificity for diagnosing pelvic floor dysfunction were 84% and 68% for reader A and 41% and 91% for reader B. Interobserver agreement was fair (kappa=0.39).

Conclusions: Architectural distortion of vaginal shape on routine pelvic MR imaging may suggest pelvic floor dysfunction but is not diagnostic.