ORLANDO, FL USA (UroToday.com) - With the emergence of dynamic pelvic MRI (DPMRI) as a diagnostic modality in the evaluation of pelvic organ prolapse (POP), there has been quality variability dependent on the performance of an adequate valsalva maneuver. This study sought to determine whether the addition of a defecography phase (DP) to DPMRI would increase its clinical utility.
Dr.Twiss reported on 56 patients were who evaluated by DPMRI, utilizing both valsalva maneuver (VM) and DP during preoperative evaluation for surgical correction of symptomatic POP. His data showed that DP produced a greater degree of pelvic organ descent compared to VM in all recorded measures for all 56 patients. Rectocele rates were 86% on VM and increased to 100% on DP. Cystocele rates were 14% on VM and increased to 71% on DP. Vaginal vault prolapse rates were 43% on VM and increased to 71% on DP.
He concluded that with valsalva maneuver alone, pelvic organs may show mild to no prolapse, but may demonstrate marked prolapse during the defecography phase. The results of this study cannot differentiate whether there is something inherent about the act of defecating that causes transient pelvic organ prolapse, and studies on normal control women without prolapse would need to be performed. Also, it is unknown whether these results correlate to clinical symptoms, and this will need to be evaluated in future studies.
Presented by Christian Twiss, MD at the Society for Pediatric Urology (SPU) Annual Meeting held concurrently with the American Urological Association (AUA) Annual Meeting - May 16 - 21, 2014 - Orlando, Florida USA
University of Arizona, Tucson, AZ USA
Written by Lara S. MacLachlan, MD of the Medical University of South Carolina, Charleston, and medical writer for UroToday.com
