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Abstract

Purpose: The purpose of this study was to assess pelvic floor dysfunction using dynamic MRI. Material & methods: A prospective study was carried out on 21 consecutive patients presenting during February 2013 to June 2013 with pelvic pain, difficulty in defecation, constipation or organ prolapse. Pelvic floor was imaged using T2-weighted and fast imaging employing steady-state acquisition sequences. Pubococcygeal line was used as the line of reference which further allowed measurement of width and vertical descent of levator hiatus. Anorectal angle was measured to assess relaxation and contraction of puborectalis muscle. Grading of prolapse was classified as mild, moderate and severe. All data was recorded both in resting and during straining phase. Results: A total of 21 patients were studied, with a mean age of 37.3 (9.4) years with 15 (71.4%) females and 6(21%) males. Dynamic MR revealed cystocele and rectocele in 7 (33.3%) patients, each. Three (14.28%) patients had enteroceles and spastic pelvic syndrome, each. Only one patient (4.76%) had descending perineal syndrome. Intussusception was observed in 10 (47.6%) patients with commonest type being intra rectal seen in 7 (33.3%) patients. Conclusion: Dynamic MRI is an ideal, non invasive technique which does not require patient preparation for evaluation of pelvic floor. It acts as one stop shop for diagnosing single or multiple pelvic compartment involvement in patients with pelvic floor dysfunction.