Assessment of daily variation in pelvic anatomy in women with and without pelvic organ prolapse

Annemarie van der Steen*, Lisan M. Morsinkhof, Luyun Chen, Mirjam de Vries, Frank F.J. Simonis, Anique T.M. Grob

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Introduction and hypothesis: Symptoms of pelvic organ prolapse (POP) can affect quality of life and are reported to progress during the day, although this was never objectified. The aim of this study is to determine whether the pelvic anatomy changes during the day using upright magnetic resonance imaging (MRI), in POP patients and asymptomatic women. Methods: In this prospective study 15 POP patients and 45 asymptomatic women were included. Upright MRI scans were obtained three times per day. The distances from the lowest points of the bladder and cervix to a standardized reference (pelvic inclination correction system) line were determined. A principal component analysis was performed on the levator plate (LP) shape. Statistical differences between time points and the groups were determined for the bladder, cervix, and LP shape. Results: For all women a significant decrease in bladder and cervix height of −0.2 cm (p<0.001) was seen between morning/midday and afternoon scans. A significant difference in bladder descent during the day between POP patients and asymptomatic women was found (p=0.004). Individual differences in bladder position in the POP group of up to 2.2 cm between the morning and afternoon scan were reported. There was a significant difference in LP shape (p<0.001) between the groups but there were no significant changes during the day. Conclusions: This study found no clinically relevant pelvic anatomy changes during the day. Still, on an individual level differences can be large, so repeating clinical examination at the end of the day can be recommended in patients when anamnesis and physical examination do not match.

Original languageEnglish
Pages (from-to)2407-2414
Number of pages8
JournalInternational Urogynecology Journal
Volume34
Issue number10
Early online date5 May 2023
DOIs
Publication statusPublished - Oct 2023

Keywords

  • Daily variation
  • Levator plate
  • Magnetic resonance imaging
  • Pelvic inclination correction system
  • Pelvic organ prolapse
  • Upright
  • UT-Hybrid-D

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