1 MR Imaging of the Female Pelvic Floor

1. Risk Factors for Pelvic Floor Defects: Pelvic floor defects are common and are seen in 50% of parous women, especially over the age of 50 [1-2]. Risk factors include: pregnancy, childbirth, hysterectomy, congenital or acquired connective tissue abnormalities, white race, denervation or weakness of the pelvic floor, advancing age, estrogen deficiency, obesity, smoking and other factors associated with chronically elevated intra-abdominal pressure. Surgery for pelvic organ prolapse and urinary incontinence is performed in 1 of 9 women [3]. Successful surgical treatment for pelvic organ prolapse involves repair of site-specific defects in pelvic floor support. Surgical failures and re-operations, reported in one third of patients, have been attributed to the lack of a thorough preoperative evaluation of the female pelvis and to inadequate diagnosis and staging of pelvic floor dysfunction [2]. MR imaging can be used in the initial evaluation of patients with pelvic organ descent, especially those who have symptoms of multicompartmental involvement and are evaluated prior to a complex pelvic floor reconstruction, or as a problem solving modality for those patients who have failed previous repairs.