MRI of the Male Pelvic Floor

Abstract

The pelvic floor is a complex structure that supports the pelvic organs and provides resting tone and voluntary control of the urethral and anal sphincters. Dysfunction of or injury to the pelvic floor can lead to gastrointestinal, urinary, and sexual dysfunction. The prevalence of pelvic floor disorders is much lower in men than in women, and because of this, the majority of the published literature pertaining to MRI of the pelvic floor is oriented toward evaluation of the female pelvic floor. The male pelvic floor has sex-specific differences in anatomy and pathophysiologic disorders. Despite these differences, static and dynamic MRI features of these disorders, specifically gastrointestinal disorders, are similar in both sexes. MRI and MR defecography can be used to evaluate anorectal disorders related to the pelvic floor. MRI can also be used after prostatectomy to help predict the risk of postsurgical incontinence, to evaluate postsurgical function by using dynamic voiding MR cystourethrography, and subsequently, to assess causes of incontinence treatment failure. Increased tone of the pelvic musculature in men secondary to chronic pain can lead to sexual dysfunction. This article reviews normal male pelvic floor anatomy and how it differs from the female pelvis; MRI techniques for imaging the male pelvis; and urinary, gastrointestinal, and sexual conditions related to abnormalities of pelvic floor structures in men.

Exploring concomitant pelvic floor symptoms in community‐dwelling females and males

“…Although males and females can present with the same PFS, key anatomical, hormonal, neuromuscular, and behavioral differences exist that result in sex and gender differences in those symptoms 21–23 . We found that more females than males reported pelvic pain.…”

“…Although males and females can present with the same PFS, key anatomical, hormonal, neuromuscular, and behavioral differences exist that result in sex and gender differences in those symptoms. [21][22][23] We found that more females than males reported pelvic pain. This finding is well known in the literature and may be explained by differences in the neuroimmune system or how sex hormones influence nociceptive systems.…”

Evaluation of Nursing Effect of Pelvic Floor Rehabilitation Training on Pelvic Organ Prolapse in Postpartum Pregnant Women under Ultrasound Imaging with Artificial Intelligence Algorithm

“…The organ prolapse of each chamber can be visually observed and quantitatively analyzed by pelvic floor ultrasound, which provides detailed pelvic floor morphological and functional information for clinical practice, and is beneficial to identify the type of prolapse. Based on the above advantages, ultrasound is widely used in the diagnosis of pelvic floor diseases [ 18 , 19 ]. However, with the deepening of people's understanding of diseases, people's requirements for the quality of ultrasonic images are also improving.…”

Systematic review and meta-analysis: gray-scale ultrasound and shear wave elastography in the diagnosis of primipara pregnancy and delivery

“…MRI relies on its own advantages of high resolution of soft tissues, capable of multi-parameter imaging and no ionizing radiation, comprehensively assessing the structure and function of the pelvic floor, and has become the imaging gold standard for evaluating the structure and function of the pelvic floor. However, the cost of MRI examination is high, the examination time is long, and the pelvic floor can't be assessed (36). Ultrasound has attracted more and more attention in the diagnosis of pelvic floor dysfunction diseases because of its unique advantages such as simple operation, real-time and fast, economical non-invasive, repeatable examination, and high resolution of soft tissues (37).…”