Role of MR defecography in assessment of post-operative repair of Pelvic Floor Dysfunction

Abstract

The female pelvic floor is a complex functional and anatomic system. As pelvic floor muscles and fasciae act like a unique functional entity, dysfunction of one compartment is commonly associated with various dysfunctions of the other compartments as well. the correct diagnosis of the specific PFD and the identification of all associated disorders are mandatory for an effective conservative or surgical treatment. Pelvic floor disorders can be treated surgically or managed with a number of non- surgical options, surgical intervention is regarded as the main strategy in the management of these conditions with variable options of surgical procedures that can be tailored based on the particular condition being treated and can be performed with transvaginal or transabdominal approaches. Non- surgical management includes (a) observation or pelvic floor muscle training for relatively asymptomatic or mild conditions; (b) biofeedback for pelvic floor dyssynergia or spastic pelvic floor syndrome or (c) placement of a pessary for prolapse in symptomatic patients who decline surgery or are poor surgical candidates or in the setting of temporary prolapse. Imaging can play an important role in the initial surgical planning and subsequently for evaluation of the outcomes and complications in the postoperative period, knowledge of the many operative procedures and their expected imaging appearances is imperative to detect complications in this setting. Different imaging techniques may be used in this clinical setting include magnetic resonance imaging, ultrasonography, voiding cystourethrography, and less commonly, computed tomography.