Can pelvic organ prolapse volume calculation via mri defecography be clinically useful in patients with rectal prolapse?

Rectal prolapse is a debilitating condition that often presents concurrently with pelvic organ (POP), but the usefulness of MRI volumes in women symptomatic rectal not well understood. Our aims were to determine clinically useful technique measure POP volume (vPOP) patients via MR defecography utilizing an estimated levator ani subtended formula (eLASV) could assist predicting patients, need for surgery, and vaginal stage. We also looked establish optimal eLASV cutoff value aid distinguishing high vs low vPOP would predict progression clinical intervention POP. This retrospective cohort study evaluated from 2017-2022 at Stanford University. Patients complaints POP-Q categorized as then subdivided by hysterectomy status creating 4 subgroups: w/ (SH), asymptomatic (AH), uterus (SU), (AU). Standard measurements obtained rest strain (Figures 1 & 2). was calculated each subject (eLASV-R) (eLASV-S) previously published equation: vPOP= -72.838+(0/598 x H-line)+(1.217 M-line)+(1.136 WLH). eLASV-R eLASV-S multivariable regression analysis predictability POP, surgery An distinguish between Youden’s index. Sensitivity specificity measuring likelihood being based on established. The 77 who met criteria into cohorts: SH (N=23), AH (N=9), SU (N=29), AU (N=16) comparison. Average age 60.4 (±14.0) years average BMI 24.5 (±5.0). predictive (p=0.004) (p=0.005) within cohort. For every unit increase (cm3) eLASV-S, odds or progressing increased 3%. either. Also, none techniques A 102.5cm3 using determined method differentiate “high” “low” since eLASV-S>102.5cm3 7.5x more likely have (95%CI: 2.65, 21.05), p<0.001 sensitivity 69% 49.2%, 84.7%) 77.1% 62.7%, 88.0%). better than it those proceeding may be helpful tool discriminate benefit evaluation floor specialist.Figure 2eLASV-S (Strain)View Large Image Figure ViewerDownload Hi-res image Download (PPT)