Dynamic Pelvic MRI or defeco MRI: Genital Prolapse
Dynamic pelvic MRI in the women, mothers and children department
A genital prolapsealso known as organ descentis a condition linked to disorders of pelvic statics, characterized by the displacement of organs in the small pelvis due to a weakening of the supporting structures. For effective diagnosis and treatment, modern imaging techniques such as dynamic pelvic MRI and MRI defecography (or defeco MRI)are playing an increasingly essential role, particularly in pre- and post-operative gynecological assessments.
You can view the video of this article on the defeco MRI with Dr Corinne Bordonné.
What is genital prolapse?
Genital prolapse is a condition mainly affecting women, often associated with other pelvic static disorders, such as urinary incontinence. It occurs when the supporting muscles and tissues of the pelvis weaken, leading to the descent of one or more pelvic organs.
Types of genital prolapse :
1. Prolapse of the bladder (Cystocele) : The bladder descends into the vaginal wall.
2. Uterine prolapse (hysterocele) : The uterus falls into the vaginal canal.
3. Rectal prolapse (Rectocele): The rectum protrudes into the posterior wall of the vagina.
These types of prolapse can be accompanied by a variety of symptoms, such as pelvic pain, difficulty in urinating or defecating, and urinary incontinence disorders, requiring tailored diagnostic and surgical approaches.
What tests are needed to diagnose genital prolapse and pelvic static disorders?
Diagnosis usually begins with a clinical gynaecological examination. However, in the event of uncertain results or for more in-depth evaluation-especially before surgery-imaging techniques such as dynamic pelvic MRI are essential.
Imaging in the preoperative workup :
APelvic MRI provides detailed mapping of pelvic static disorders, enabling assessment of supporting tissues, prolapse severity and any associated muscle dysfunction. This information is crucial for planning surgery and identifying possible post-operative complications.
When should ultrasound be used in cases of prolapse?
Aultrasound is an important complementary method for exploring the lesser pelvis before and after surgery for prolapse or urinary incontinence.
Preoperative applications :
- Assessment of pelvic organs such as the uterus and ovaries.
- Analysis of perineal muscles to identify weaknesses or lesions.
- Dynamic assessment of pelvic static disorders during pushing maneuvers.
Postoperative uses : Check the position of surgical implants, such as slings, to ensure correct placement, particularly in the case of urinary incontinence surgery.
Defeco MRI RDV
Book an appointment for dynamic pelvic MRI at our centers:
MRI Bachaumont 75002
IRM Pôle Santé Bergère 75009
MRI Blomet 75015
Is MRI defecography (or dynamic pelvic MRI) systematic?
A defeco MRIa specialized variant of thePelvic MRI dynamic, is not systematic but plays a crucial role in certain contexts. It is particularly useful after surgery or to explore specific disorders of the small pelvis.
Key applications of defeco MRI :
1. Assessment of posterior colpoceles: Identify whether the protrusion involves the rectum, peritoneum or other organs.
2. Analysis of defecation disorders: Useful for diagnosing problems such as anism or anal incontinence.
3. Assessment of postoperative recurrence: Verification of the integrity of surgical repairs.
4. Prosthesis mapping: visualizes the position of implanted materials during surgery.
5. Nerve pathway analysis: May include the pudendal nerve to assess nerve involvement in pelvic dysfunction.
Although it differs from conventional pelvic MRI, MRI defeco offers an unrivalled level of detail for dynamic assessments, particularly in complex cases.
How is an MRI defeco performed?
For accurate diagnosis of pelvic statics disorders, including prolapse, careful preparation of the patient is essential.
Here's how it works:
1. Preparation: The patient performs a bladder enema and is asked to urinate beforehand.
2. Positioning: The patient lies supine with legs semi-flexed to ensure comfort and stability.
3. Rectal and vaginal opacification: Ultrasound gel is used to improve visibility of the rectum and vagina.
4. Dynamic instructions: The patient is invited to perform pushing maneuvers while wearing a helmet for clear communication with the technician.
5. No intravenous contrast: The examination relies entirely on the opacified organs and the patient's movements.
This systematic approach makes it possible to accurately identify prolapse and associated disorders.
What treatments are available for prolapse and associated disorders?
Surgical treatments :
- Autologous vaginal surgery: uses the patient's own tissue to restore support to the pelvic organs.
- Abdominal surgery (promontofixation): Fixation of prolapsed organs to the sacral promontory with synthetic mesh.
- Colpocleisis: Vaginal canal closure technique for advanced cases where vaginal function is no longer a priority.
These surgical approaches target specific needs and adapt to the severity of pelvic static disorders, particularly in cases of severe prolapse or associated urinary incontinence.
A genital prolapse and pelvic static disordersThese conditions, such as urinary incontinence, have a considerable impact on patients' quality of life, particularly in older women. Advanced techniques such asDynamic pelvic MRI and MRI defecography offer precise diagnosis and optimal surgical treatment planning for disorders of the small pelvis. These modern tools ensure personalized care, tailored to the specific needs of each patient.
MRI defeco FAQs
1- Is defeco MRI painful?
No, the examination is painless. However, the use of gel for opacification may be slightly uncomfortable. Our technicians take great care to ensure the best possible experience for the patient.
2- Can dynamic pelvic MRI detect urinary incontinence?
Yes, it can be used to assess pelvic static disorders, including pelvic floor muscle dysfunctions that may be linked to urinary incontinence.
Last update: December 22, 2024
Dr Corinne Bordonné
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