Pelvic floor dysfunction occurs, especially in women, after difficult births, vaginal surgery and with increasing age. The consequences are fecal and urinary incontinence and/or difficulties with bowel and bladder emptying. It can also lead to protrusions of bowel loops, the bladder and the uterus.
Magnetic resonance imaging (MRI) is today’s method of choice for comprehensive functional imaging diagnostics of the pelvic floor. In contrast to imaging the pelvic floor with X-rays (X-ray defecography or video defecography), there is no radiation exposure and all pelvic organs, including the small bowel loops and the urinary bladder, are imaged without the need to administer a contrast agent.
The loops of the small intestine in particular cannot be visualized with any other functional procedure apart from the pelvic floor MRI. However, a lowering of the small bowel loops during pushing (enterocele) often determines which surgical procedure can be used, e.g. to remove a protrusion of the rectal wall (rectocele), so that functional pelvic floor MRI is practically indispensable before such an operation.
Our recommendation
A detailed examination of the pelvic floor using MRI can help to identify weaknesses or injuries to the pelvic floor muscles and determine the cause of incontinence or pain.
The examination only takes a few minutes. Before the examination, the rectum is filled with a special examination gel, a painless procedure. During the examination, there is verbal contact between the MRI team and the patient via microphone and headphones. First, images of the entire pelvis are taken to rule out malformations, inflammations and tumors as the cause of the symptoms and to see if the pelvic floor muscles are tightened. Instructions are then given to alternately tense, relax and squeeze the pelvic floor and, if necessary, to empty it.
A live video, which is created from a lateral view, shows the changes in position of the individual organs during these maneuvers, allowing important conclusions to be drawn about the presence or extent of pelvic floor weakness and any accompanying illnesses. Preparation such as laxation or fasting are not necessary. No contrast agent or medication is injected. No medication needs to be discontinued before the examination.
Preparation such as laxation or fasting are not necessary. No contrast agent or medication is injected. No medication needs to be discontinued before the examination.
Our recommendation
Regular preventive care is important.
Adults up to the age of 40 should be screened every 4 years, and every 2 years after that.
