Static magnetic resonance imaging of the pelvic floor muscle morphology in women with stress urinary incontinence and pelvic prolapse

Tunn, Ralf; Paris, S.; Fischer, W.; Hamm, Bernd; Kuchinke, Jörg

doi:10.1002/(sici)1520-6777(1998)17:6<579::aid-nau2>3.0.co;2-r

Cited by 104 publications

(63 citation statements)

References 20 publications

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“…Bo et al [67] have also studied the changes in the pelvic floor with contraction and straining and found no differences between continent and incontinent women. Tunn et al [68] found a higher signal intensity of levator musculature and a loss of the hammock-like configuration of the anterior vaginal wall in women with stress incontinence. MRI has been shown to detect more levator herniae, although the clinical significance of this finding remains unclear [69].…”

Section: Investigationmentioning

confidence: 87%

Combined urinary and faecal incontinence

2005

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Combined urinary and faecal (liquid or solid) incontinence (double incontinence) is the most severe and debilitating manifestation of pelvic floor dysfunction. The community prevalence is 9-19% (urinary) and 5-10% (faecal), increasing with age. Pathophysiological factors include childbirth-associated external anal sphincter injury and pudendal nerve damage, pelvic floor descent, menopause, collagen disorders and multiple sclerosis-like conditions. The presence of crossed reflexes between the bladder, urethra, anorectum and pelvic floor in animal studies may explain the comorbidity of urinary and faecal urgency. Surgical treatment is based on aetiology and combined optimum techniques such as colposuspension or suburethral sling with overlapping sphincteroplasty. Other methods for improving sphincteric control include sacral nerve neuromodulation, bulking agents and artificial sphincters.

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Section: Investigationmentioning

confidence: 87%

Combined urinary and faecal incontinence

2005

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“…Levator ani should be symmetric without defects or fraying. Abnormal signal in the levator muscle, when compared to the obturator internus, and thinning can be observed in patients with stress incontinence and can be a result of fatty infiltration and atrophy as well as direct muscle injury [24] . The normal thickness of the PRM is 56 mm [25] .…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

Macura

Thompson

Bluemke

et al. 2015

WJR

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AIM:To define the magnetic resonance imaging (MRI) parameters differentiating urethral hypermobility (UH) and intrinsic sphincter deficiency (ISD) in women with stress urinary incontinence (SUI). METHODS:The static and dynamic MR images of 21 patients with SUI were correlated to urodynamic (UD) findings and compared to those of 10 continent controls. For the assessment of the urethra and integrity of the urethral support structures, we applied the highresolution endocavitary MRI, such as intraurethral MRI, endovaginal or endorectal MRI. For the functional imaging of the urethral support, we performed dynamic MRI with the pelvic phased array coil. We assessed the following MRI parameters in both the patient and the

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“…MR imaging has objectively demonstrated these defects in women with stress urinary incontinence and pelvic organ prolapse particularly in the region of the pubovisceral portion of the levator ani [Tunn et al, 1998;Hoyte et al, 2001]. This part of the muscle, also known as the pubococcygeal muscle and attaches the pelvic organs, including the tissues that support the urethra, to the pubic bones.…”

Section: Introductionmentioning

confidence: 99%

Interrater reliability and physical examination of the pubovisceral portion of the levator ani muscle, validity comparisons using MR imaging

Kearney

Miller

DeLancey

2005

Neurourology and Urodynamics

116

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Aims-Defects in the pubovisceral portion of the levator ani muscle are seen with MR imaging. This study aims to determine interrater reliability of physical examination in detecting these defects, and to validate findings from physical examination using comparisons with MR images Methods-Two examiners palpated the pubovisceral muscles of 29 women to assess for defects in this muscle. Each examiner was blinded to the others findings. MR scans were acquired on a further 24 women after structured clinical examination by one examiner. These images were read to determine pubovisceral muscle defects, blinded to patient identifiers. Agreement between raters and between MR imaging and clinical examination were calculated.Results-The two examiners had positive agreement (presence of a defect) of 72.7% and negative agreement (absence of a defect) of 83.3%. The positive agreement between physical examination and MR imaging was 27.3% and the negative agreement 86.5% Conclusion-The structured physical examination to detect defects in the pubovisceral portion of the levator ani muscle can be learned as shown by good interrater agreement. However, examination alone underestimates these defects compared with MR imaging.

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Static magnetic resonance imaging of the pelvic floor muscle morphology in women with stress urinary incontinence and pelvic prolapse

Cited by 104 publications

References 20 publications

Combined urinary and faecal incontinence

Combined urinary and faecal incontinence

Magnetic resonance imaging in assessment of stress urinary incontinence in women: Parameters differentiating urethral hypermobility and intrinsic sphincter deficiency

Interrater reliability and physical examination of the pubovisceral portion of the levator ani muscle, validity comparisons using MR imaging

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