MR imaging in posthysterectomy vaginal prolapse

In the diagnostic work-up of vaginal prolapse after hysterectomy cystoceles can be identified by sonography, whereas enteroceles and rectoceles can on ly be suspected in a routine clinical setting. The present pilot study was undertaken to investigate the diagnostic role of magnetic resonance imaging (MRI) in the differentiation of cysto-, entero- and rectoceles in women wi th posthysterectomy vaginal prolapse. Thirteen women (mean age 61, SD +/- 7 years) with posthysterectomy vaginal prolapse underwent MRI (Gyroscan S 15 , Philips). A median sagittal image series was obtained with a gradient-ech o sequence, fast field echo, both at rest and during Valsalva maneuvers. MR I allowed the identification of cysto-, entero- and rectoceles, and differe ntiation between entero- and rectoceles in cases with inconclusive clinical findings. These findings make dissection more reliable and improve the out come of hernia repair. No additional diagnostic information is obtained wit h MRI compared to ultrasound in the assessment of cystoceles.