Pelvic floor evaluation with dynamic fluoroscopy

Abstract

Objective: To evaluate dynamic fluoroscopy of the pelvic floor for the study of women with pelvic floor disorders.

Methods: In a prospective, observational study in a tertiary care referral center, 30 women with prolapse beyond the introitus underwent comprehensive fluoroscopic imaging of the pelvic floor.

Results: Dynamic fluoroscopy of the pelvic floor was technically possible in all patients. Whereas the physical examinations appeared relatively similar in these patients, the fluoroscopic examination revealed distinct differences. Of the 30 women, 25 had a cystocele, 25 had a rectocele, and 26 had an enterocele. Eleven patients had their surgical plan modified accordingly. Pelvic floor fluoroscopy is not a test for urinary or fecal incontinence. However, incontinence was demonstrated objectively in ten women (eight with fecal incontinence, two with urinary incontinence).

Conclusion: Dynamic fluoroscopy of the pelvic floor is a useful adjunct in the clinical evaluation of women with prolapse. This imaging can be used to individualize the operative approach to prolapse. It is superior to clinical examination for the detection of enterocele formation. In addition, it provides information regarding the emptying function of the rectocele, which is not obtainable on physical examination.