MRI Pelvis Dynamic Maneuvers without Defecation To our knowledge, there is no relevant literature regarding the utility of MRI pelvis with dynamic maneuvers (dynamic pelvic floor MRI) specifically in patients with UI or voiding dysfunction; however, dynamic pelvic floor MRI allows for global functional and anatomic assessment of the pelvic floor, including depiction of cystoceles, location of urethrovesical junction, assessment of urethral angle, urethral hypermobility and/or kinking [50,61]. Dynamic pelvic floor MRI with straining rather than defecation demonstrates lower prevalence of prolapse in multiple compartments [12,15,26-29]. This may lower detection rates of cystoceles in patients with UI, although the clinical impact of this lower detection rate has not been reported in the literature to our knowledge. Furthermore, the inherent high soft-tissue contrast resolution of MRI allows for anatomic evaluation of the pelvic organs, including the bladder and urethra, as well as urethral ligaments [37], and postoperative changes if present. MRI of the pelvis can demonstrate differences in pelvic floor musculature and bladder-neck morphology and urethrovesical angle when comparing patients with SUI, mixed UI, and continence [62]. MRI can also depict morphological alterations in the urethra, urethral ligaments, and vaginal fascia in patients with SUI [63-65]. Although not considered the initial imaging test of choice, MR pelvis dynamic maneuvers without defecation may be utilized for assessment of patients with urinary dysfunction in the appropriate clinical setting. MRI Pelvis To our knowledge, there is no relevant literature regarding the use of MRI pelvis without defecation or straining for functional evaluation of urinary dysfunction; however, pelvic floor MRI allows for anatomic assessment of the pelvic floor, including location of urethrovesical junction, and assessment of urethral angle at rest [61].
Pelvic Floor Dysfunction in Females. MRI Pelvis Dynamic Maneuvers without Defecation To our knowledge, there is no relevant literature regarding the utility of MRI pelvis with dynamic maneuvers (dynamic pelvic floor MRI) specifically in patients with UI or voiding dysfunction; however, dynamic pelvic floor MRI allows for global functional and anatomic assessment of the pelvic floor, including depiction of cystoceles, location of urethrovesical junction, assessment of urethral angle, urethral hypermobility and/or kinking [50,61]. Dynamic pelvic floor MRI with straining rather than defecation demonstrates lower prevalence of prolapse in multiple compartments [12,15,26-29]. This may lower detection rates of cystoceles in patients with UI, although the clinical impact of this lower detection rate has not been reported in the literature to our knowledge. Furthermore, the inherent high soft-tissue contrast resolution of MRI allows for anatomic evaluation of the pelvic organs, including the bladder and urethra, as well as urethral ligaments [37], and postoperative changes if present. MRI of the pelvis can demonstrate differences in pelvic floor musculature and bladder-neck morphology and urethrovesical angle when comparing patients with SUI, mixed UI, and continence [62]. MRI can also depict morphological alterations in the urethra, urethral ligaments, and vaginal fascia in patients with SUI [63-65]. Although not considered the initial imaging test of choice, MR pelvis dynamic maneuvers without defecation may be utilized for assessment of patients with urinary dysfunction in the appropriate clinical setting. MRI Pelvis To our knowledge, there is no relevant literature regarding the use of MRI pelvis without defecation or straining for functional evaluation of urinary dysfunction; however, pelvic floor MRI allows for anatomic assessment of the pelvic floor, including location of urethrovesical junction, and assessment of urethral angle at rest [61].