PELVIC FLOOR EVALUATION WITH DYNAMIC FLUOROSCOPY

Objective: To evaluate dynamic fluoroscopy of the pelvic floor for the study of women with pelvic floor disorders. Methods: In a prospective , observational study in a tertiary care referral center, 30 women wit h prolapse beyond the introitus underwent comprehensive fluoroscopic i maging of the pelvic floor. Results: Dynamic fluoroscopy of the pelvic floor was technically possible in all patients. Whereas the physical examinations appeared relatively similar in these patients, the fluoro scopic examination revealed distinct differences. Of the 30 women, 25 had a cystocele, 25 had a rectocele, and 26 had an enterocele. Eleven patients had their surgical plan modified accordingly. Pelvic floor fl uoroscopy is not a test for urinary or fecal incontinence. However, in continence was demonstrated objectively in ten women (eight with fecal incontinence, two with urinary incontinence). Conclusion: Dynamic flu oroscopy of the pelvic floor is a useful adjunct in the clinical evalu ation of women with prolapse. This imaging can be used to individualiz e the operative approach to prolapse. It is superior to clinical exami nation for the detection of enterocele formation. In addition, it prov ides information regarding the emptying function of the rectocele, whi ch is not obtainable on physical examination.