MRI of pelvic organ prolapse

Excerpt

The purpose of MR imaging for pelvic organ prolapse (POP) is to determine the position of the pelvic organs and pelvic floor. POP is a common disorder of symptomatic descent of the pelvic organs [1]. Multiple abnormalities are often present due to defects in the endopelvic fascia that supports the bladder, uterus, small bowel and rectum. The type of organ prolapsing is only inferred on physical examination, and imaging allows direct visualization, which is particularly helpful for the diagnosis of enteroceles, sigmoidoceles and rectoceles and can alter clinical management [2‐7]. These entities can be difficult to distinguish and only 50% of enteroceles are diagnosed on physical examination [2, 3]. In one study of 20 patients, additional diagnoses of POP were made in 34% on MR [5]. MR imaging provides a global picture of POP and the success of surgical therapy can also be demonstrated. In all patients, the findings on imaging have to be correlated with the patient’s symptoms and physical exam to determine if therapy is necessary. Organ descent that meets imaging criteria for prolapse but is asymptomatic is not corrected. …