Dynamic MR imaging of pelvic organ prolapse: Spectrum of abnormalities

Pelvic organ prolapse is a relatively common condition in women that can ha ve a significant impact on quality of life. Pelvic organ prolapse typically demonstrates multiple abnormalities and may involve the urethra, bladder, vaginal vault, rectum, and small bowel. Patients may present with pain, pre ssure, urinary and fecal incontinence, constipation, urinary retention, and defecatory dysfunction. Diagnosis is made primarily on the basis of findin gs at physical pelvic examination. Imaging is useful in patients in whom fi ndings at physical examination are equivocal. Fluoroscopy, ultrasonography, and magnetic resonance (MR) imaging can be useful in evaluating pelvic org an prolapse. Advantages of MR imaging include lack of ionizing radiation, d epiction of the soft tissues of the pelvic floor, and multiplanar imaging c apability. Dynamic imaging is usually necessary to demonstrate pelvic organ prolapse, which may be obvious only when abdominal pressure is increased. Treatment is more likely to be successful if a survey of the entire pelvis is performed prior to therapy. Therapy is usually undertaken only in sympto matic patients. In all patients, imaging findings must be interpreted in co njunction with physical examination findings and the patient's symptoms.