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. 2006 Jun 1;126(2):239-45.
doi: 10.1016/j.ejogrb.2005.10.018. Epub 2005 Nov 17.

MRI morphology of the levator ani muscle, endopelvic fascia, and urethra in women with stress urinary incontinence

Ralf Tunn  1 , Kathrin Goldammer, Jörg Neymeyer, Annett Gauruder-Burmester, Bernd Hamm, Dirk Beyersdorff
Affiliations

MRI morphology of the levator ani muscle, endopelvic fascia, and urethra in women with stress urinary incontinence

Ralf Tunn et al. Eur J Obstet Gynecol Reprod Biol. .

Abstract

Objective: To evaluate pathomorphologic changes of the levator ani muscle, endopelvic fascia, and urethra in women with stress urinary incontinence (SUI) by MRI.

Study design: Fifty-four women with SUI were examined by MRI (1.5T): body phased-array coil, axial and coronal proton-density-weighted sequences.

Results: The urethral sphincter muscle showed a reduced thickness of its posterior portion (37%), an omega shape (13%) or higher signal intensity (50%); its abnormal configuration was associated with an increased signal intensity in 70% (p=0.001). The levator ani muscle comprised an unilateral loss of substance in 30%, a higher signal intensity in 28%, and altered origin in 19%. Central defects of the endopelvic fascia were present in 39% (n=21), lateral defects in 46%. There was a significant association between loss of the symphyseal concavity of the anterior vaginal wall and lateral fascial defects (p=0.001) and levator ani changes (p=0.016).

Conclusion: MRI yields findings supporting current theories on the pathogenesis of SUI.

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