Static and dynamic MRI of a urinary control intra-vaginal device |
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Authors: | A J Maubon M P Boncoeur-Martel V Juhan C R Courtieu A S Thurmond P Aubas P Marès J P Rouanet |
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Institution: | Department of Medical Imaging, C.M.C. Beausoleil, Montpellier, France. |
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Abstract: | The aim of this study was to describe by MRI, in dynamic conditions at rest and straining, the anatomical modifications induced
by a commercially available intravaginal device (IVD) aimed at relieving female stress urinary incontinence. Ten female patients
complaining of stress urinary incontinence (SUI) had pelvic MRI with static and dynamic sequences, without and with a self-inserted
IVD. We studied positions and angulations of the IVD in the pelvis. Paired t-test allowed comparisons of: position of the bladder neck; urethral angulation with the pubis axis; position of the urethra;
and posterior urethro-vesical angle (PUVA) without and with IVD. At rest, in ten of ten cases IVD laid cranial to the pubo-rectal
muscle; with an average angulation of 95 ± 10 ° with the pubis axis, laterally tilted in three of ten cases. In maximum straining
with IVD bladder neck descent was lower by an average of 5.2 ± 3.1 mm (p = 0.001), pubo-urethral angle opening was smaller by an average of 22 ± 20 °(p = 0.015), and bladder neck to pubis distance was shorter by an average of 5.7 ± 4 mm. Posterior urethro-vesical angle was
not significantly modified. Dynamic MRI allowed a non-invasive assessment of the mode of action of an IVD. The main modifications
were a support of the bladder base and bladder neck, with a superior displacement of the urethra toward the pubis.
Received: 6 October 1999; Revised: 17 January 2000; Accepted: 18 January 2000 |
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Keywords: | : Stress urinary incontinence – Intra-vaginal device – MRI – Dynamic MRI |
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