MRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approach
Abstract Background Stress urinary incontinence (SUI) is a common disabling pelvic floor dysfunction, particularly among aging women. Magnetic resonance imaging (MRI) with dynamic sequences has been proven reliable for detecting pelvic floor weaknesses, especially with multiple compartments defects....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2023-03-01
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| Series: | The Egyptian Journal of Radiology and Nuclear Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43055-023-00998-y |
| _version_ | 1797865204565934080 |
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| author | Sherif Fathy Abdelrahman Mohamed A. Abdelatty Basma Amer Sara Mahmoud Kamel Ahmed Fathy Hussein Rania Farouk El Sayed |
| author_facet | Sherif Fathy Abdelrahman Mohamed A. Abdelatty Basma Amer Sara Mahmoud Kamel Ahmed Fathy Hussein Rania Farouk El Sayed |
| author_sort | Sherif Fathy Abdelrahman |
| collection | DOAJ |
| description | Abstract Background Stress urinary incontinence (SUI) is a common disabling pelvic floor dysfunction, particularly among aging women. Magnetic resonance imaging (MRI) with dynamic sequences has been proven reliable for detecting pelvic floor weaknesses, especially with multiple compartments defects. Since surgical and non-surgical management options exist, detailed imaging analysis and comprehension of the various surgical and non-surgical interventions are crucial for surgical planning and postoperative evaluation. However, patients often present with recurrent or new symptoms after surgery, where MR imaging is necessary to detect complications in this setting. We aimed to analyze MR images pre- and postoperative/intervention using the defect-specific approach aiming at better understanding of the underlying complication and/or the cause of recurrence. Results Thirty female patients with SUI were included in the study; 20 underwent surgery, 6 were treated by physiotherapy only, while 3 patients underwent both surgery and physiotherapy and 1 patient was treated conservatively. According to their clinical symptoms, patients with successful surgical/physiotherapy outcome were 18 cases (60%), while unsuccessful group comprised of 12 cases (40%) is classified as follows: persistent complaints subgroup 7 patients (23.3%), de novo complaint subgroup 2 patients (6.7%), while the complicated subgroup is comprised of 2 patients (6.7%) and the persistent/de novo complaints subgroup of the unsuccessful group is composed of 1 case (3.3%). They all underwent MRI of the pelvic floor with a standardized technique, pre- and postoperative/physiotherapy. Changes in level III endopelvic fascia defects between the pre- and postoperative/physiotherapy studies were statistically significant (p = 0.045). Urinary bladder and uterine descent were also found statistically significant between the pre- and postoperative/physiotherapy studies (p = 0.001 and p = 0.029, respectively). Comparing successful and unsuccessful groups pre- and postoperative/therapy, levator plate angle (LPA) was found statistically significant as well (p = 0.039 preoperative and p = 0.001 postoperative). Conclusions Analysis of the pre- and postoperative static and dynamic MRI sequences along with proper understanding of the preformed intervention can pinpoint the underlying pathology leading to the recurrent or de novo symptom and/or complications. The defect-specific approach can help determine the underlying pelvic floor defect by altering the MRI techniques tailored for each patient according to their complaint. |
| first_indexed | 2024-04-09T23:05:26Z |
| format | Article |
| id | doaj.art-96cd4035b0264704be1d4fc159d9330c |
| institution | Directory Open Access Journal |
| issn | 2090-4762 |
| language | English |
| last_indexed | 2024-04-09T23:05:26Z |
| publishDate | 2023-03-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | The Egyptian Journal of Radiology and Nuclear Medicine |
| spelling | doaj.art-96cd4035b0264704be1d4fc159d9330c2023-03-22T10:45:48ZengSpringerOpenThe Egyptian Journal of Radiology and Nuclear Medicine2090-47622023-03-0154111010.1186/s43055-023-00998-yMRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approachSherif Fathy Abdelrahman0Mohamed A. Abdelatty1Basma Amer2Sara Mahmoud Kamel3Ahmed Fathy Hussein4Rania Farouk El Sayed5Radiology Department, Kasr Al-Alainy Faculty of Medicine, Cairo University Hospitals, Cairo UniversityRadiology Department, Kasr Al-Alainy Faculty of Medicine, Cairo University Hospitals, Cairo UniversityRadiology Department, Kasr Al-Alainy Faculty of Medicine, Cairo University Hospitals, Cairo UniversityRadiology Department, Kasr Al-Alainy Faculty of Medicine, Cairo University Hospitals, Cairo UniversityUrology Department, Kasr Al-Alainy Faculty of Medicine, Cairo UniversityRadiology Department, Kasr Al-Alainy Faculty of Medicine, Cairo University Hospitals, Cairo UniversityAbstract Background Stress urinary incontinence (SUI) is a common disabling pelvic floor dysfunction, particularly among aging women. Magnetic resonance imaging (MRI) with dynamic sequences has been proven reliable for detecting pelvic floor weaknesses, especially with multiple compartments defects. Since surgical and non-surgical management options exist, detailed imaging analysis and comprehension of the various surgical and non-surgical interventions are crucial for surgical planning and postoperative evaluation. However, patients often present with recurrent or new symptoms after surgery, where MR imaging is necessary to detect complications in this setting. We aimed to analyze MR images pre- and postoperative/intervention using the defect-specific approach aiming at better understanding of the underlying complication and/or the cause of recurrence. Results Thirty female patients with SUI were included in the study; 20 underwent surgery, 6 were treated by physiotherapy only, while 3 patients underwent both surgery and physiotherapy and 1 patient was treated conservatively. According to their clinical symptoms, patients with successful surgical/physiotherapy outcome were 18 cases (60%), while unsuccessful group comprised of 12 cases (40%) is classified as follows: persistent complaints subgroup 7 patients (23.3%), de novo complaint subgroup 2 patients (6.7%), while the complicated subgroup is comprised of 2 patients (6.7%) and the persistent/de novo complaints subgroup of the unsuccessful group is composed of 1 case (3.3%). They all underwent MRI of the pelvic floor with a standardized technique, pre- and postoperative/physiotherapy. Changes in level III endopelvic fascia defects between the pre- and postoperative/physiotherapy studies were statistically significant (p = 0.045). Urinary bladder and uterine descent were also found statistically significant between the pre- and postoperative/physiotherapy studies (p = 0.001 and p = 0.029, respectively). Comparing successful and unsuccessful groups pre- and postoperative/therapy, levator plate angle (LPA) was found statistically significant as well (p = 0.039 preoperative and p = 0.001 postoperative). Conclusions Analysis of the pre- and postoperative static and dynamic MRI sequences along with proper understanding of the preformed intervention can pinpoint the underlying pathology leading to the recurrent or de novo symptom and/or complications. The defect-specific approach can help determine the underlying pelvic floor defect by altering the MRI techniques tailored for each patient according to their complaint.https://doi.org/10.1186/s43055-023-00998-yPelvic floor dysfunctionUrinary incontinenceMRI |
| spellingShingle | Sherif Fathy Abdelrahman Mohamed A. Abdelatty Basma Amer Sara Mahmoud Kamel Ahmed Fathy Hussein Rania Farouk El Sayed MRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approach The Egyptian Journal of Radiology and Nuclear Medicine Pelvic floor dysfunction Urinary incontinence MRI |
| title | MRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approach |
| title_full | MRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approach |
| title_fullStr | MRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approach |
| title_full_unstemmed | MRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approach |
| title_short | MRI of the pelvic floor in female patients with stress urinary incontinence, pre- and postoperative and/or physiotherapy: analysis of the defect-specific approach |
| title_sort | mri of the pelvic floor in female patients with stress urinary incontinence pre and postoperative and or physiotherapy analysis of the defect specific approach |
| topic | Pelvic floor dysfunction Urinary incontinence MRI |
| url | https://doi.org/10.1186/s43055-023-00998-y |
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