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International Urogynecology Journal

Published in:

01-09-2010 | Original Article

Magnetic resonance imaging-based three-dimensional model of anterior vaginal wall position at rest and maximal strain in women with and without prolapse

Authors: Kindra A. Larson, Yvonne Hsu, Luyun Chen, James A. Ashton-Miller, John O. L. DeLancey

Published in: International Urogynecology Journal | Issue 9/2010

Abstract

Introduction and hypothesis

Two-dimensional magnetic resonance imaging (MRI) demonstrates apical support and vaginal length contribute to anterior wall prolapse (AWP). This paper describes a novel three-dimensional technique to examine the vagina and its relationship to pelvic sidewalls at rest and Valsalva.

Methods

Twenty women (10 with AWP and 10 with normal support) underwent pelvic magnetic resonance imaging at rest and Valsalva. Three-dimensional reconstructions of the pelvic bones and anterior vaginal wall were created to assess morphologic changes occurring in prolapse.

Results

In women with AWP, Valsalva caused downward translation of the vagina along its length. A transition point separated a proximal region supported by levator muscles and a distal, unsupported region no longer in contact with the perineal body. In this latter region, sagittal and frontal plane “cupping” occurs. The distal vagina rotated inferiorly along an arc centered on the inferior pubis.

Conclusion

Downward translation, cupping, and distal rotation are three novel characteristics of AWP demonstrated by this three-dimensional technique.

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Title: Magnetic resonance imaging-based three-dimensional model of anterior vaginal wall position at rest and maximal strain in women with and without prolapse
Authors: Kindra A. Larson
Yvonne Hsu
Luyun Chen
James A. Ashton-Miller
John O. L. DeLancey
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: International Urogynecology Journal / Issue 9/2010
Print ISSN: 0937-3462
Electronic ISSN: 1433-3023
DOI: https://doi.org/10.1007/s00192-010-1161-x

At a glance: The STEP trials

Springer Medicine

Magnetic resonance imaging-based three-dimensional model of anterior vaginal wall position at rest and maximal strain in women with and without prolapse

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction and hypothesis

Methods

Results

Conclusion

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