Pelvic Floor Failure: MR Imaging Evaluation of Anatomic and Functional Abnormalities

Bitti, Grazia; Argiolas, Giovanni Maria; Ballicu, Nicola; Caddeo, Elisabetta; Cecconi, Martina; Demurtas, Giovanna; Matta, Gildo; Peltz, Maria Teresa; Secci, Simona; Siotto, Paolo

doi:10.1148/rg.342125050

Cited by 80 publications

(71 citation statements)

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“…At MR imaging, it is defined as a descent of the bladder base below the PCL. It may be associated with damage to the urethral suspension ligaments and urinary incontinence (19 …”

Section: Stage IVmentioning

confidence: 99%

Agreement of Manual Exam (POP-Q) with Pelvic MRI in Assessment of Anterior Pelvic Organ Prolapse

et al. 2016

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Background: Pelvic floor dysfunction (PFD) refers to a wide range of issues that occur when muscles of the pelvic floor are weak, tight, or there is an impairment of the sacroiliac joint, lower back, coccyx, or hip joints. PFD and pelvic organ prolapse (POP) affect about 50% of women past middle age. Symptoms include pelvic pain, pressure, dyspareunia, incontinence, incomplete emptying, and gross organ protrusion. Nowadays, there are novel diagnostic tools and therapies proposed for pelvic floor weakness and organ prolapse. Pelvic organ prolapse quantification system (POP-Q) examination and complementary magnetic resonance imaging (MRI) are two methods of diagnosis. Objectives: The goal of our study was to assess the agreement between POP-Q examination and MRI in detecting anterior pelvic prolapses. In addition, we evaluated the additive role of MRI adjunct to POP-Q examination in detecting anterior pelvic organ prolapse. Patients and Methods: An experimental study was carried out on 61 patients having clinical manifestations suggesting pelvic floor weakness. The medical history and physical examination were obtained from all patients. POP-Q examination and dynamic MR imaging was performed. POP-Q results were compared with dynamic MRI findings thereafter. Results: Considering pubococcygeal line (PCL) and H line as reference lines, comparison of MRI and POP-Q findings for detecting bladder neck and urethra prolapses revealed a moderate to good agreement (49% -80%) rate between MRI and POP-Q examination. This corresponds to a weak to moderate agreement between these two methods. Conclusion: Agreement of MRI and POP-Q is moderate to good for detecting anterior pelvic organs prolapses. MRI could be regarded as a complementary method to POP-Q examination. A combination diagnostic approach, including MRI and POP-Q, for high stage pelvic prolapse is highly recommended.

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“…At MR imaging, it is defined as a descent of the bladder base below the PCL. It may be associated with damage to the urethral suspension ligaments and urinary incontinence (19 …”

Section: Stage IVmentioning

confidence: 99%

Agreement of Manual Exam (POP-Q) with Pelvic MRI in Assessment of Anterior Pelvic Organ Prolapse

et al. 2016

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“…The examination was prospectively carried out between September 2014 and February 2015 on 26 consecutive patients (three men, 23 …”

Section: Patient Populationmentioning

confidence: 99%

Prospective Comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling

et al. 2015

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• A standardized MRI technique for assessing pelvic floor disorders is not yet established. • This study compares two MRI techniques based on different rectal filling: air-balloon versus gel. • Both MRI techniques proved to be valuable in assessing PFD, with good agreement. • Air-balloon technique is more hygienic and better tolerated than the gel-filling technique. • Gel was superior for rectal invagination, air-balloon for rectocele and uro-genital prolapses.

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“…Na maioria dos estudos aqui apresentados, é possível notar que a incidência e epidemiologia das disfunções do diafragma da pelve são bem definidas. O sexo feminino, idade avançada, menopausa e predisposição genética são os principais fatores de risco, podendo incluir ainda a obesidade, gravidez e paridade, ressaltando que os mecanismos relacionados à "falha" do diafragma da pelve ainda não são totalmente compreendidos (12) . Geralmente a SHA se manifesta na infância ou no início da idade adulta, podendo ser um marcador precoce de risco (4) e resultar em alterações do diafragma da pelve em mulheres (20) .…”

Section: Resultsunclassified

“…Uma irregularidade na estrutura e repartição do colágeno tipo I, somado a um aumento da proporção do colágeno tipo III, aparenta ser uma causa subjacente da SHAB, o que pode resultar na diminuição da rigidez generalizada e flacidez dos ligamentos (11) . O diafragma da pelve é considerado o diafragma musculofascial fixado nos ossos pélvicos que atua funcionalmente no parto vaginal, função sexual e controle da abertura inferior, fornecendo, assim, o apoio estático para órgãos viscerais e durante o fechamento ativo do hiato urogenital, proporcionando os mecanismos de esvaziamento e de continência (12) . Sabe-se que o tecido conectivo dos ligamentos de suporte da parede vaginal é formado por matriz extracelular (MEC), que possui maior predomínio de componentes fibrilares (colágeno e elastina).…”

Section: Introductionunclassified

“…Alguns estudos realizados para investigar a epidemiologia dos distúrbios do diafragma da pelve preconizam que, algumas mulheres podem ser fenotipica ou genotipicamente propensas a desenvolver essas alterações que podem apresentar-se como sintomas do trato urinário, sintomas sexuais e sintomas intestinais (16) . Uma em cada nove mulheres passará por procedimento invasivo para tratamento de incontinência urinária ou prolapso de órgãos pélvicos e 30% precisarão de cirurgia adicional em virtude da recidiva dos sintomas (12) . O POP é definido como a descida de um ou mais dos seguintes: parede vaginal anterior, parede vaginal posterior e vértice da vagina (colo do útero/útero) ou abóbada (braçadeira) após histerectomia.…”

Section: Introductionunclassified

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Síndrome De Hipermobilidade Articular Nos Pacientes Com Disfunções Do Diafragma Da Pelve: Revisão De Literatura

Leal

Cavenaghi

Carvalho

2016

ACS

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Con lito de interesses:Não Contribuição dos autores: TTL delineamento do estudo, elaboração e redação do manuscrito. SC orientação e delineamento do estudo. LHC orientação do projeto. Abstract Introduction: Joint hypermobility is the ability to perform joint movements with greater amplitude than normal. We use the term "hypermobility syndrome joint" when there is a combination of extra-skeletal and musculoskeletal signs and symptoms that include a larger number of detaching disorders, including pelvic dysfunction. Pelvic floor dysfunction is a broad term that encompasses urinary incontinence and prolapse of pelvic organs considered greatly prevalent. Objective: Update knowledge of the association between joint hypermobility and dysfunction of the pelvic floor in the common population. Patients and Methods: English and Portuguese articles were selected published between 2010 and 2015 in the electronic databases PubMed, LILACS, and SciELO. Results: The structure of this study was based on references that present significant aspects related to the demand of our research. It comprises 11 studies showing significance in the results towards the existence of the relationship between joint hypermobility and changes in the pelvic floor. Conclusion: It is believed that existing alterations in the collagen composition can be the main cause of the relationship between Articular hypermobility and dysfunction of the pelvic floor. In general, the articles examined in this update tend to support this relationship. However, future implications of this new knowledge for better practice should be considered. Contato para correspondência: Talita Teixeira LealDescriptors: Joint Instability; Pelvic Floor; Collagen.

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Pelvic Floor Failure: MR Imaging Evaluation of Anatomic and Functional Abnormalities

Cited by 80 publications

References 50 publications

Agreement of Manual Exam (POP-Q) with Pelvic MRI in Assessment of Anterior Pelvic Organ Prolapse

Agreement of Manual Exam (POP-Q) with Pelvic MRI in Assessment of Anterior Pelvic Organ Prolapse

Prospective Comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling

Síndrome De Hipermobilidade Articular Nos Pacientes Com Disfunções Do Diafragma Da Pelve: Revisão De Literatura

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