To outline key imaging techniques and recommendations for assessing pelvic floor dysfunction.
Approach:
MR Defecography: MR defecography should be used for comprehensive assessment of pelvic floor dysfunction, particularly in complex multicompartment disease or after prior surgery, provided high-quality images are obtained with adequate patient cooperation.
Conventional Fluoroscopic Defecography: Conventional fluoroscopic defecography is a valuable tool in evaluating defecatory dysfunction despite the widespread use of MR defecography. It can be used to provide crucial information when an MRI is inconclusive and may yield more representative functional information.
Endoanal Ultrasound: Endoanal ultrasound is the preferred modality for assessing anal sphincter integrity, offering superior sensitivity in detecting internal anal sphincter tears and comparable sensitivity to MRI in external anal sphincter tears.
Key Findings:
MR defecography is effective for complex pelvic floor dysfunction assessments.
Fluoroscopic defecography remains important for functional evaluation when MRI is inconclusive.
Endoanal ultrasound is the most sensitive method for detecting anal sphincter tears.
Interpretation:
The pelvic floor should be assessed holistically due to the interconnected nature of its compartments.
Limitations:
Variability in imaging preparation and techniques across different centers.
Patient cooperation is essential for accurate imaging results.
Conclusion:
A combination of imaging modalities is often necessary for a comprehensive evaluation of pelvic floor dysfunction.
by Mohamed A. Abdelatty, Aleksandra Stankiewicz, Francesca Maccioni, Rebeca Mirón Mombiela, Basma Amer, Sandra Sousa, Sonya Snape, Carlos Carnelli, Rita Lucas, Geertje Balk-Roos, Andelib Babatürk, Rania F. El Sayed
