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Pelvic Floor Dysfunction

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Gynecological Imaging

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Abstract

The pelvic floor is a complex system, with passive and active components that provide pelvic support, maintain continence, and coordinate relaxation during urination and defecation [1].

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References

  1. Stoker J, Halligan S, Bartram CI (2001) Pelvic floor imaging. Radiology 218:621–641

    PubMed  CAS  Google Scholar 

  2. Bump RC, Norton PA (1998) Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am 25:723–746

    Article  PubMed  CAS  Google Scholar 

  3. DeLancey JO (1993) Anatomy and biomechanics of genital prolapse. Clin Obstet Gynecol 36:897–909

    Article  PubMed  CAS  Google Scholar 

  4. Jelovsek JE, Maher C, Barber MD (2007) Pelvic organ prolapse. Lancet 369:1027–1038

    Article  PubMed  Google Scholar 

  5. Deval B, Haab F (2003) What’s new in prolapse surgery? Curr Opin Urol 13:315–323

    Article  PubMed  Google Scholar 

  6. Fielding JR (2002) Practical MR imaging of female pelvic floor weakness. Radiographics 22:295–304

    PubMed  Google Scholar 

  7. Luber KM, Boero S, Choe JY (2001) The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynecol 184:1496–1501; discussion 1501–1503

    Article  PubMed  CAS  Google Scholar 

  8. DeLancey JO (2005) The hidden epidemic of pelvic floor dysfunction: achievable goals for improved prevention and treatment. Am J Obstet Gynecol 192:1488–1495

    Article  PubMed  Google Scholar 

  9. Shorvon PJ, McHugh S, Diamant NE, Somers S, Stevenson GW (1989) Defecography in normal volunteers: results and implications. Gut 30:1737–1749

    Article  PubMed  CAS  Google Scholar 

  10. Bump RC, Mattiasson A, Bo K et al (1996) The standardization of terminology of female pelvic organ prolapse and pelvic floor dysfunction. Am J Obstet Gynecol 175:10–17

    Article  PubMed  CAS  Google Scholar 

  11. Roos JE, Weishaupt D, Wildermuth S, Willmann JK, Marincek B, Hilfiker PR (2002) Experience of 4 years with open MR defecography: pictorial review of anorectal anatomy and disease. Radiographics 22:817–832

    PubMed  Google Scholar 

  12. Preston DM, Lennard-Jones JE (1985) Anismus in chronic constipation. Dig Dis Sci 30:413–418

    Article  PubMed  CAS  Google Scholar 

  13. Bates P, Bradley WE, Glen E et al (1979) The standardization of terminology of lower urinary tract function. J Urol 121:551–554

    PubMed  CAS  Google Scholar 

  14. Terra MP, Stoker J (2006) The current role of imaging techniques in faecal incontinence. Eur Radiol 16:1727–1736

    Article  PubMed  CAS  Google Scholar 

  15. Kearney R, Sawhney R, DeLancey JO (2004) Levator ani muscle anatomy evaluated by origin-insertion pairs. Obstet Gynecol 104:168–173

    Article  PubMed  Google Scholar 

  16. Singh K, Reid WM, Berger LA (2002) Magnetic resonance imaging of normal levator ani anatomy and function. Obstet Gynecol 99:433–438

    Article  PubMed  Google Scholar 

  17. Critchley HO, Dixon JS, Gosling JA (1980) Comparative study of the periurethral and perianal parts of the human levator ani muscle. Urol Int 35:226–232

    Article  PubMed  CAS  Google Scholar 

  18. Margulies RU, Hsu Y, Kearney R, Stein T, Umek WH, DeLancey JO (2006) Appearance of the levator ani muscle subdivisions in magnetic resonance images. Obstet Gynecol 107:1064–1069

    Article  PubMed  Google Scholar 

  19. Tunn R, Delancey JO, Howard D, Ashton-Miller JA, Quint LE (2003) Anatomic variations in the levator ani muscle, endopelvic fascia, and urethra in nulliparas evaluated by magnetic resonance imaging. Am J Obstet Gynecol 188:116–121

    Article  PubMed  Google Scholar 

  20. DeLancey JO, Morgan DM, Fenner DE et al (2007) Comparison of levator ani muscle defects and function in women with and without pelvic organ prolapse. Obstet Gynecol 109:295–302

    Article  PubMed  Google Scholar 

  21. Jackson SR, Avery NC, Tarlton JF, Eckford SD, Abrams P, Bailey AJ (1996) Changes in metabolism of collagen in genitourinary prolapse. Lancet 347:1658–1661

    Article  PubMed  CAS  Google Scholar 

  22. Boreham MK, Wai CY, Miller RT, Schaffer JI, Word RA (2002) Morphometric properties of the posterior vaginal wall in women with pelvic organ prolapse. Am J Obstet Gynecol 187:1501–1508; discussion 1508–1509

    Article  PubMed  Google Scholar 

  23. Boreham MK, Wai CY, Miller RT, Schaffer JI, Word RA (2002) Morphometric analysis of smooth muscle in the anterior vaginal wall of women with pelvic organ prolapse. Am J Obstet Gynecol 187:56–63

    Article  PubMed  Google Scholar 

  24. Singh K, Jakab M, Reid WM, Berger LA, Hoyte L (2003) Three-dimensional magnetic resonance imaging assessment of levator ani morphologic features in different grades of prolapse. Am J Obstet Gynecol 188:910–915

    Article  PubMed  Google Scholar 

  25. Loubeyre P, Copercini M, Petignat P, Dubuisson JB (2012) Levator ani muscle complex: anatomic findings in nulliparous patients at thin-section MR imaging with double opacification. Radiology 262:538–543

    Article  PubMed  Google Scholar 

  26. Weidner AC, Jamison MG, Branham V, South MM, Borawski KM, Romero AA (2006) Neuropathic injury to the levator ani occurs in 1 in 4 primiparous women. Am J Obstet Gynecol 195:1851–1856

    Article  PubMed  CAS  Google Scholar 

  27. Snooks SJ, Barnes PR, Swash M (1984) Damage to the innervation of the voluntary anal and periurethral sphincter musculature in incontinence: an electrophysiological study. J Neurol Neurosurg Psychiatry 47:1269–1273

    Article  PubMed  CAS  Google Scholar 

  28. Mattox TF, Lucente V, McIntyre P, Miklos JR, Tomezsko J (2000) Abnormal spinal curvature and its relationship to pelvic organ prolapse. Am J Obstet Gynecol 183:1381–1384; discussion 1384

    Article  PubMed  CAS  Google Scholar 

  29. Nguyen JK, Lind LR, Choe JY, McKindsey F, Sinow R, Bhatia NN (2000) Lumbosacral spine and pelvic inlet changes associated with pelvic organ prolapse. Obstet Gynecol 95:332–336

    Article  PubMed  CAS  Google Scholar 

  30. DeLancey JO (1986) Correlative study of paraurethral anatomy. Obstet Gynecol 68:91–97

    PubMed  CAS  Google Scholar 

  31. Lienemann A, Anthuber C, Baron A, Reiser M (2000) Diagnosing enteroceles using dynamic magnetic resonance imaging. Dis Colon Rectum 43:205–212; discussion 212–213

    Article  PubMed  CAS  Google Scholar 

  32. Macura KJ, Genadry RR, Bluemke DA (2006) MR imaging of the female urethra and supporting ligaments in assessment of urinary incontinence: spectrum of abnormalities. Radiographics 26:1135–1149

    Article  PubMed  Google Scholar 

  33. Kelvin FM, Maglinte DD, Hornback JA, Benson JT (1992) Pelvic prolapse: assessment with evacuation proctography (defecography). Radiology 184:547–551

    PubMed  CAS  Google Scholar 

  34. Pannu HK, Kaufman HS, Cundiff GW, Genadry R, Bluemke DA, Fishman EK (2000) Dynamic MR imaging of pelvic organ prolapse: spectrum of abnormalities. Radiographics 20:1567–1582

    PubMed  CAS  Google Scholar 

  35. Maglinte DD, Bartram CI, Hale DA et al (2011) Functional imaging of the pelvic floor. Radiology 258:23–39

    Article  PubMed  Google Scholar 

  36. Kelvin FM, Hale DS, Maglinte DD, Patten BJ, Benson JT (1999) Female pelvic organ prolapse: diagnostic contribution of dynamic cystoproctography and comparison with physical examination. AJR Am J Roentgenol 173:31–37

    Article  PubMed  CAS  Google Scholar 

  37. Kelvin FM, Maglinte DD, Hale DS, Benson JT (2000) Female pelvic organ prolapse: a comparison of triphasic dynamic MR imaging and triphasic fluoroscopic cystocolpoproctography. AJR Am J Roentgenol 174:81–88

    Article  PubMed  CAS  Google Scholar 

  38. Schoenenberger AW, Debatin JF, Guldenschuh I, Hany TF, Steiner P, Krestin GP (1998) Dynamic MR defecography with a superconducting, open-configuration MR system. Radiology 206:641–646

    PubMed  CAS  Google Scholar 

  39. Etlik O, Arslan H, Odabasi O et al (2005) The role of the MR-fluoroscopy in the diagnosis and staging of the pelvic organ prolapse. Eur J Radiol 53:136–141

    Article  PubMed  Google Scholar 

  40. Mellgren A, Johansson C, Dolk A et al (1994) Enterocele demonstrated by defaecography is associated with other pelvic floor disorders. Int J Colorectal Dis 9:121–124

    Article  PubMed  CAS  Google Scholar 

  41. Maubon A, Martel-Boncoeur MP, Juhan V et al (2000) Static and dynamic magnetic resonance imaging of the pelvic floor. J Radiol 81:1875–1886

    PubMed  CAS  Google Scholar 

  42. Woodfield CA, Krishnamoorthy S, Hampton BS, Brody JM (2010) Imaging pelvic floor disorders: trend toward comprehensive MRI. AJR Am J Roentgenol 194:1640–1649

    Article  PubMed  Google Scholar 

  43. Margulies RU, Huebner M, DeLancey JO (2007) Origin and insertion points involved in levator ani muscle defects. Am J Obstet Gynecol 196:251.e1–255.e1

    Article  Google Scholar 

  44. Law YM, Fielding JR (2008) MRI of pelvic floor dysfunction: review. AJR Am J Roentgenol 191:S45–S53

    Article  PubMed  Google Scholar 

  45. Huddleston HT, Dunnihoo DR, Huddleston PM 3rd, Meyers PC Sr (1995) Magnetic resonance imaging of defects in DeLancey’s vaginal support ­levels I, II, and III. Am J Obstet Gynecol 172:1778–1782; discussion 1782–1784

    Article  PubMed  CAS  Google Scholar 

  46. Kim JK, Kim YJ, Choo MS, Cho KS (2003) The urethra and its supporting structures in women with stress urinary incontinence: MR imaging using an endovaginal coil. AJR Am J Roentgenol 180:1037–1044

    Article  PubMed  Google Scholar 

  47. El Sayed RF, El Mashed S, Farag A, Morsy MM, Abdel Azim MS (2008) Pelvic floor dysfunction: assessment with combined analysis of static and dynamic MR imaging findings. Radiology 248:518–530

    Article  PubMed  Google Scholar 

  48. Rociu E, Stoker J, Zwamborn AW, Lameris JS (1999) Endoanal MR imaging of the anal sphincter in fecal incontinence. Radiographics 19 Spec No:S171–S177

    PubMed  CAS  Google Scholar 

  49. Boyadzhyan L, Raman SS, Raz S (2008) Role of static and dynamic MR imaging in surgical pelvic floor dysfunction. Radiographics 28:949–967

    Article  PubMed  Google Scholar 

  50. Comiter CV, Vasavada SP, Barbaric ZL, Gousse AE, Raz S (1999) Grading pelvic prolapse and pelvic floor relaxation using dynamic magnetic resonance imaging. Urology 54:454–457

    Article  PubMed  CAS  Google Scholar 

  51. Yang A, Mostwin JL, Rosenshein NB, Zerhouni EA (1991) Pelvic floor descent in women: dynamic evaluation with fast MR imaging and cinematic display. Radiology 179:25–33

    PubMed  CAS  Google Scholar 

  52. Hetzer FH, Andreisek G, Tsagari C, Sahrbacher U, Weishaupt D (2006) MR defecography in patients with fecal incontinence: imaging findings and their effect on surgical management. Radiology 240:449–457

    Article  PubMed  Google Scholar 

  53. Singh K, Reid WM, Berger LA (2001) Assessment and grading of pelvic organ prolapse by use of dynamic magnetic resonance imaging. Am J Obstet Gynecol 185:71–77

    Article  PubMed  CAS  Google Scholar 

  54. Lienemann A, Anthuber C, Baron A, Kohz P, Reiser M (1997) Dynamic MR colpocystorectography assessing pelvic-floor descent. Eur Radiol 7:1309–1317

    Article  PubMed  CAS  Google Scholar 

  55. Kelvin FM, Maglinte DD, Benson JT, Brubaker LP, Smith C (1994) Dynamic cystoproctography: a technique for assessing disorders of the pelvic floor in women. AJR Am J Roentgenol 163:368–370

    Article  PubMed  CAS  Google Scholar 

  56. Felt-Bersma RJ, Cuesta MA (2001) Rectal prolapse, rectal intussusception, rectocele, and solitary rectal ulcer syndrome. Gastroenterol Clin North Am 30:199–222

    Article  PubMed  CAS  Google Scholar 

  57. Mahieu P, Pringot J, Bodart P (1984) Defecography: I. Description of a new procedure and results in normal patients. Gastrointest Radiol 9:247–251

    Article  PubMed  CAS  Google Scholar 

  58. Kelvin FM, Maglinte DD, Benson JT (1994) Evacuation proctography (defecography): an aid to the investigation of pelvic floor disorders. Obstet Gynecol 83:307–314

    PubMed  CAS  Google Scholar 

  59. Halligan S, Bartram CI, Park HJ, Kamm MA (1995) Proctographic features of anismus. Radiology 197:679–682

    PubMed  CAS  Google Scholar 

  60. Mortele KJ, Fairhurst J (2007) Dynamic MR defecography of the posterior compartment: indications, techniques and MRI features. Eur J Radiol 61:462–472

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Service Radiologie, Hopital Hotel-Dieu, Paris, France

    Jean Noel Buy

  2. Department of Radiology, Hotel Dieu de France, Beirut, Lebanon

    Michel Ghossain

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  1. Jean Noel Buy
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  2. Michel Ghossain
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Buy, J.N., Ghossain, M. (2013). Pelvic Floor Dysfunction . In: Gynecological Imaging. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-31012-6_37

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  • DOI: https://doi.org/10.1007/978-3-642-31012-6_37

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  • Online ISBN: 978-3-642-31012-6

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