Abstract
The dynamic anatomical response of the normal pelvic floor to voluntary pelvic floor contractions was documented using magnetic resonance imaging. Sequences of coronal, sagittal and transverse images in the relaxed and the contracted state were obtained from 17 young, asymptomatic volunteers trained to perform pelvic floor exercises correctly. The images were processed digitally and computer colored to indicate dynamic changes produced as a result of contractions. Gross transverse sections through a human female cadaver were photographed and digitized to provide a reference of pelvic anatomy. A 3D rendition of the processed MR images was made to illustrate the extent of pelvic floor contraction. The results illustrate the changes produced by voluntary pelvic floor contractions in all planes scanned. Quantitative measurements of selective structures around the bladder were made to show the magnitude of pelvic floor displacement during contraction. The dynamic imaging illustrates the extent of changes in the normal pelvic floor that are produced by pelvic floor exercises and give a measure of the displacement of the bladder and the levator ani.
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Editoral Comment: Magnetic resonance imaging has recently been found useful in the evaluation of the pelvic floor in patients with stress incontinence. Firm, convincing information in normal subjects has been lacking, however. This study of normal volunteers provides a great deal of information on the activity of the pelvic floor. We are grateful to the authors for the opportunity to present these illustrations in color. They are to be congratulated on this fine study and we trust that they will also provide similar information in stress incontinent and prolapse patients in the future.
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Christensen, L.L., Djurhuus, J.C., Lewis, M.T. et al. MRI of voluntary pelvic floor contractions in healthy female volunteers. Int Urogynecol J 6, 138–152 (1995). https://doi.org/10.1007/BF01900574
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DOI: https://doi.org/10.1007/BF01900574