The Contribution of Magnetic Resonance Imaging of the Pelvic Floor to the Understanding of Urinary Incontinence

Kirschner‐Hermanns, Ruth; Wein, B.; Niehaus, S.; Schaefer, Werner; Jakse, G.

doi:10.1111/j.1464-410x.1993.tb16254.x

Cited by 115 publications

(51 citation statements)

References 8 publications

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“…Despite this general appreciation of the muscle's importance, scientific study of the muscle has begun only recently with the advent of MR imaging that can objectively visualize normal and abnormal muscle anatomy. Evidence of muscle damage have been reported in women with pelvic organ prolapse and stress urinary incontinence and progress is being made to assess what specific role this muscle injury plays in the pathogenesis of these common problems [Berglas and Rubin, 1953;Koelbl et al, 1989;Hoyte et al, 2001;Kirschner-Hermanns et al, 1993]. Because the medial margin of the levator ani muscle is connected to the urethral supports [DeLancey 1988] and the target of treatment with pelvic muscle exercise, the status of the levator ani muscle has particular implications for stress urinary incontinence.…”

Section: Discussionmentioning

confidence: 99%

Interrater reliability and physical examination of the pubovisceral portion of the levator ani muscle, validity comparisons using MR imaging

Kearney

Miller

DeLancey

2005

Neurourology and Urodynamics

115

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Aims-Defects in the pubovisceral portion of the levator ani muscle are seen with MR imaging. This study aims to determine interrater reliability of physical examination in detecting these defects, and to validate findings from physical examination using comparisons with MR images Methods-Two examiners palpated the pubovisceral muscles of 29 women to assess for defects in this muscle. Each examiner was blinded to the others findings. MR scans were acquired on a further 24 women after structured clinical examination by one examiner. These images were read to determine pubovisceral muscle defects, blinded to patient identifiers. Agreement between raters and between MR imaging and clinical examination were calculated.Results-The two examiners had positive agreement (presence of a defect) of 72.7% and negative agreement (absence of a defect) of 83.3%. The positive agreement between physical examination and MR imaging was 27.3% and the negative agreement 86.5% Conclusion-The structured physical examination to detect defects in the pubovisceral portion of the levator ani muscle can be learned as shown by good interrater agreement. However, examination alone underestimates these defects compared with MR imaging.

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Section: Discussionmentioning

confidence: 99%

Interrater reliability and physical examination of the pubovisceral portion of the levator ani muscle, validity comparisons using MR imaging

Kearney

Miller

DeLancey

2005

Neurourology and Urodynamics

115

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“…Assessment of the anatomical changes of the pelvic floor muscles in women with SUI has been investigated by magnetic resonance imaging [8, 21], transvaginal ultrasound [22, 23], transrectal ultrasound [24]and transperineal ultrasound [13]. Among these investigated methods, transrectal ultrasound provides a dynamic and clear investigation of the urethra and paraurethral structures.…”

Section: Introductionmentioning

confidence: 99%

The Relationships of Urethral and Pelvic Floor Muscles and the Urethral Pressure Measurements in Women with Stress Urinary Incontinence

Kuo¹

2000

European Urology

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“…Morphologische Ver~inde-rungen, das heil3t Areale, wo ein Muskel gesch¡ wurde oder ganz fehlt und durch Fettgewebe ersetzt wurde, lassen sich identifizieren [13]. So beschreiben Kirschner-Hermanns et al [8] …”

Section: Diskussionunclassified

Anale Sphinkterstärke und Sphinktervolumetrie in der endovaginalen hochauflösenden MRT bei gesunden Nulliparae

et al. 1997

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Anale Sphinkterst~irke und Sphinktervolumetrie in der endovaginalen hochaufl6senden MRT bei gesunden Nulliparae Zusammenfassung. Die endovaginale Magnetresonanztomographie (MRT) erm6glicht eine hochaufl6sen-de Abbildung des Beckenbodens, insbesondere der Muskelschichten des analen Sphinkterkomplexes. Bei sieben gesunden Nulliparae wurden St~ke und Volumen der analen Muskulatur bestimmt. Im Vergleich zu publizierten sonographischen Daten sind die Megwerte fª die Starke des Musculus sphincter ani internus im MRT grti8er, die Werte fª die Dicke des Musculus sphincter ani externus dagegen kleiner. Dies ist durch eine detailliertere Abbildung der Muskelschichten im MRT und eine deutlichere Abgrenzung der Umgebungsstrukturen erkl~rbar. Mit Hilfe der erhaltenen Normwerte sollten sich anatomische Vertinderungen des analen Sphinkters im Sinne einer Hypertrophie bzw. Atrophie leicht beurteilen lassen. Die endovaginale MRT ist ein hilfreiches Instrument in der Diagnostik morphologischer Sphinkterver~nderungen der weiblichen analen Inkontinenz. (Schlª Analer Sphinkter. MRT. Endovaginalspule)Anal Sphincter Size and Volumetric Data in Healthy Nulliparae Assessed by Endovaginal MRI Summary. Magnetic resonance imaging (MRI) using an endovaginal surface coil provides high resolution imaging of the muscles of the pelvic floor and especially the anal canal. In 7 healthy nulliparae anal sphincter size and anal sphincter volume were defined. MRI of the sphincter muscles revealed -when compared by sonography -the sphincter ani internus muscle to be thicker and the sphi, ncter ani externus muscle correspondingty smaller. This can be explained by the more detailed resolution of the muscle layers, and the better contrast to the surrounding structures obtained by MRI: By defining the normal values for the size of the anal sphincter anatomical changes associated with hypertrophy and atrophy could be readily shown. 242H. B. G. Franz, M. P. Mª S. Papadopoulou, et al. coloproctology 19 (1997), 242-246 (Nr. 6)

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The Contribution of Magnetic Resonance Imaging of the Pelvic Floor to the Understanding of Urinary Incontinence

Cited by 115 publications

References 8 publications

Interrater reliability and physical examination of the pubovisceral portion of the levator ani muscle, validity comparisons using MR imaging

Interrater reliability and physical examination of the pubovisceral portion of the levator ani muscle, validity comparisons using MR imaging

The Relationships of Urethral and Pelvic Floor Muscles and the Urethral Pressure Measurements in Women with Stress Urinary Incontinence

Anale Sphinkterstärke und Sphinktervolumetrie in der endovaginalen hochauflösenden MRT bei gesunden Nulliparae

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