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ECR 2019 / C-2282
Cum Laude
Imaging evaluation of pelvic floor: Pictorial review of the most recent recommendations
Congress: ECR 2019
Poster No.: C-2282
Type: Educational Exhibit
Keywords: Imaging sequences, MR-Functional imaging, MR, Urinary Tract / Bladder, Pelvis, Genital / Reproductive system female, Pelvic floor dysfunction
Authors: P. M. Costa1, D. Monteiro2, A. Silva1, C. A. R. A. Silva3, M. Ribeiro1, J. A. Machado2; 1Matosinhos/PT, 2Porto/PT, 3Guimarães/PT
DOI:10.26044/ecr2019/C-2282

Background

Pelvic floor dysfunction (PFD) is a wide spectrum of functional conditions that result from pelvic floor’s supporting structures abnormalities. These conditions are associated with great impairment of quality of life, as they can cause:

  • Stress urinary incontinence
  • Faecal incontinence
  • Constipation
  • Difficulty in voiding
  • Chronic pain
  • Pelvic organ prolapse
  • Sense of pressure
  • Sexual dysfunction 

 

Female sex and ageing are considered the most important risk factors for PFD, which affects approximately half of women older than 50 years, being a major cause of loss of quality of life in the ageing female patients.

 

Thus, it is easy to understand that the ageing of the population had lead to an increasing incidence of PFD, representing a great burden in medical care.

 

Treatment of PFD is complex, frequently involving surgical repair. However, surgical options differ accordingly to the underlying defect and patients with PFD often present with abnormalities in multiple pelvic floor compartments, leading to unsatisfactory results, with postoperative recurrence rates as high as 30% in population-based studies [1].

 

As physical and clinical examination have obvious limitations in the evaluation of defects in the anatomic structures and often result in misidentification of the compartments involved, imaging evaluation prior to the surgical repair has been of increasing importance.

 

MRI, with the ability to visualize all the three pelvic compartments, allows the identification of the specific anatomic and structural abnormalities, which, along with the symptom complex, will lead to a treatment tailored to each patient. [2]

 

However, the way pelvic floor MRI is performed and reported by radiologists is still poorly standardized, which lead a panel of radiologists with expertize in pelvic floor imaging to create the "Joint recommendations of the ESUR and ESGAR Pelvic Floor Working Group". [3]

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