Because VCUG is performed in the physiologic upright position and involves focused imaging of the bladder and urethra during active voiding, it may be used as the initial imaging test for evaluation of patients with urinary dysfunction when deemed necessary after appropriate clinical evaluation. The general limitation of this minimally invasive study is that it is limited to anterior compartment structures. MR Defecography MR defecography has utility in global functional and anatomic assessment of the pelvic floor, including depiction of cystoceles, location of urethrovesical junction at rest and defecation, assessment of urethral angle, urethral Pelvic Floor Dysfunction in Females hypermobility and/or kinking [50,61]. To our knowledge, there is no relevant literature regarding the utility of MR defecography specifically in patients with UI or voiding dysfunction. 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 MR defecography provides evaluation of all pelvic floor compartments and is not considered the initial imaging test of choice, it may be utilized for assessment of patients with urinary dysfunction in the appropriate clinical setting.
Pelvic Floor Dysfunction in Females. Because VCUG is performed in the physiologic upright position and involves focused imaging of the bladder and urethra during active voiding, it may be used as the initial imaging test for evaluation of patients with urinary dysfunction when deemed necessary after appropriate clinical evaluation. The general limitation of this minimally invasive study is that it is limited to anterior compartment structures. MR Defecography MR defecography has utility in global functional and anatomic assessment of the pelvic floor, including depiction of cystoceles, location of urethrovesical junction at rest and defecation, assessment of urethral angle, urethral Pelvic Floor Dysfunction in Females hypermobility and/or kinking [50,61]. To our knowledge, there is no relevant literature regarding the utility of MR defecography specifically in patients with UI or voiding dysfunction. 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 MR defecography provides evaluation of all pelvic floor compartments and is not considered the initial imaging test of choice, it may be utilized for assessment of patients with urinary dysfunction in the appropriate clinical setting.