Dynamic magnetic resonance imaging following native tissue vaginal reconstructive surgery; a prospective study

• Published in: International Urogynecology Journal 2021-06, Vol.32 (6), p.1519-1525
• Main Authors: Shatkin-Margolis, Abigail, Duke, Eugene, Ghodsi, Vivian, Hill, Austin, Crisp, Catrina C., Pauls, Rachel N.
• Format: Article
• Language: English
• Subjects: Defecation; Gynecology; Magnetic resonance imaging; Medicine; Medicine & Public Health; Original Article; Pelvic organ prolapse; Surgery; Urology; Vagina
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-020-04571-3

Introduction and hypothesis To describe the impact of native tissue vaginal reconstruction on pelvic anatomy using dynamic magnetic resonance imaging. Methods This prospective single-cohort observational study involved women undergoing native tissue reconstruction with intraperitoneal vaginal vault suspension for pelvic organ prolapse. Concomitant procedures such as hysterectomy, midurethral sling, and anterior or posterior colporrhaphy were allowed. Enrolled participants underwent dynamic pelvic imaging pre- and postoperatively. Radiographic and anatomic measurements were compared. Secondary outcomes included validated patient questionnaires. Results Fourteen participants were included in the analysis. The mean age was 62 years; all participants were Caucasian. Most participants had stage III pelvic organ prolapse. Significant improvements were noted in several radiographic measurements. The average H-line (representing levator hiatus width) with straining maneuvers improved following surgery (7.2 cm preoperatively vs. 6.6 cm postoperatively, p  = 0.015). The average M-line (representing levator muscular descent) improved significantly with both straining (4.0 cm preoperatively vs. 3.0 cm postoperatively, p