Functional Imaging in Rectal Prolapse

Abstract

Imaging data has gained great relevance in the preoperative assessment of severe pelvic organ prolapse, including vaginal vault descent, enterocele, rectocele and cystocele. This is at least partly due to inaccurate characterisation and failure to identify all of the involved sites when using physical examination alone, leading to incomplete surgical repair with subsequent persistence or recurrence of the prolapse. Despite their potential advantages in determining which organs are involved, however, available imaging procedures, i.e. contrast radiography, ultrasonography and, more recently, dynamic magnetic resonance imaging (MRI), still share some important limitations, such as lack of standardisation, validation and availability. In fact, existing methods of performing examinations and measurements of individual parameters vary greatly among researchers, making comparison of study results difficult. In addition, significant differences still exist in the definition and terminology of the most common pelvic descent processes as well as in the classification and quantification systems adopted.