Case challenge · Imaging / Gynecology / Pelvic floor · teaching

Dynamic Pelvic Floor MRI · Pelvic Organ Prolapse (HMO) · case challenge

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Case #1Imaging / Gynecology / Pelvic floor

📋 Case data

Dynamic pelvic floor MRI (HMO, strain/defecation phase)Mild-moderate prolapse/pelvic floor laxity (H 6–10 cm, M 2–6 cm, organ descends 1–6 cm below the PCL)

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Step 1 / 1 · Dynamic pelvic floor MRI (HMO, strain/defecation phase)

Dynamic pelvic floor MRI (HMO system, maximal strain/defecation phase) findings?

💡 Dynamic pelvic floor MRI (MR defecography) assesses all three compartments (anterior = bladder-urethra, middle = uterus-vagina, posterior = rectum-anal canal). Gel in the rectum (± vagina), sagittal SSFP at rest/squeeze/strain/defecation phases (the defecation phase detects prolapse better than Valsalva alone). Reference lines: PCL (pubococcygeal line: inferior pubic symphysis to last coccygeal segment), H line (inferior pubic symphysis to anorectal junction, normal ~5 cm), M line (perpendicular from PCL to the posterior end of the H line, normal ~2 cm). Prolapse = an organ descending below the PCL on strain.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.