Female pelvic organ prolapse: Baseline and post-operative evaluation using dynamic MRI

Purpose: We have investigated the possible use of dynamic MR imaging in the baseline and post-operative evaluation of female urinary incontinence and genital prolapse. Material and Methods: From Jan. 2001 to Sept. 2002, 32 female patients with a diagnosis of genuine stress urinary incontinence associated with various degrees of genital prolapse were investigated using dynamic MR imaging. The examinations were performed using a Philips Intera system operating at 1.5T. Patients were placed in a dorsal position with the legs slightly flexed and abducted. Two-hundred and fifty ml of Gd-DTPA water solution (0.3%) were instilled in the bladder. Twenty ml of Gadolinium water-gel solution (0.3%) were injected in the vagina and 50 ml in the rectum. Dynamic images were obtained in resting conditions and during Valsalva manoeuvre using T1 FFE sequences (FOV 250-300 mm, thickness 3 mm) in the sagittal plane. Results: Dynamic imaging provided in all cases good demonstration of genital prolapse during Valsalva manoeuvre; a good correlation, in the baseline and after surgical treatment, between clinical diagnosis of genital prolapse type and degree obtained at physical examination versus MRI was found. Conclusion: In our opinion quantification of genital prolapse using dynamic MRI may be of value in surgical planning and post-surgical follow–up.