Klassifikation der Beckenbodeninsuffizienz mit Hilfe der Magnetresonanztomographie (MRT) — ein Schritt zur rationalen Therapie

56 patients suffering from descending perineum syndrome (DPS) were investigated protocologically and by dynamic magnetic resonance imaging (dMRI), that was performed after filling the rectum with contrast media. Dynamic magnetic resonance imaging allowed the accurate evaluation of cystoceles, genital prolapses, rectoceles, enteroceles and external rectal prolapses. However, internal rectal prolapses and mucosal prolapses were diagnosed only in 2 of 10 patients. Based on the findings in dMRI, a new classification of descending perineum syndrome was developed dividing DPS in 4 disease stages. Each of these stages is characterized by a typical constellation of MRI results which facilitates the selection of the adequate treatment. In conclusion, dMRI of the pelvic floor is the most important imaging procedure in planning the correct therapy of DPS, thereby making cystography and defaecography dispensable.