Uterus Prolaps

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Uterine prolapse. Sagittal midline TrueFISP image at rest revealing an everted uterus filling of the vaginal space, which extends below the distal third of the vagina. Red line: PCL; purple line: extent of the uterine prolapse

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Rectal prolapse with a moderate uterine prolapse. (a, b, c) Sagittal midline TrueFISP images at the beginning (a), middle (b), and end (c) of the evacuation phase demonstrating a rectal intussusception extending beyond the anal sphincter (red arrows). Note also that it is accompanied by a moderate uterine prolapse and a peritoneocele, both aggravating along the different times of the evacuation phase. Red line: PCL; purple line: extent of the uterine prolapse

Dynamic

magnetic resonance imaging of the female pelvic floor—a pictorial review. Descending perineal syndrome with tricompartimental prolapse. (a, b) Sagittal midline TruFISP images at rest (a) and during evacuation (b). H line (blue line) measures 7.7 cm (a) and 9.8 cm (b) and the M line (green line) measures 2.3 cm (a) and 4.5 cm (b), demonstrating widening and descent of the levator hiatus, even at rest but aggravating during defecation. It is also associated with tricompartimental prolapse, with a severe cystocele and a severe uterine everted prolapse. Note the verticalization of the levator plate (white arrow). Another interesting finding is that the rectal contrast is only partially expelled (b), because the mass effect by both the cystocele and uterine prolapse induces mechanical posterior obstruction (dilated rectum filled with ultrasound gel) causing constipation and incomplete evacuation (*). (c) Axial T2-TSE image at the pubic symphysis plane showing bilateral ureterohydronephosis causes by the cystocele (red arrows)