[MRI evaluation of surgical pelvic floor repair].
OBJECTIVE
To bring to the fore the differences in terms of anatomical restoration between the abdominal and vaginal approach of pelvic floor repair. We compared the short-term anatomical results of the sacropexy and the sacrospinous fixation and paravaginal repair.


METHODS
Magnetic Resonance Imagery (MRI) allowed us to obtain a reproducible and objective comparison of location of the various pelvic organs. Forty-three patients benefited from a MRI a pre- and postoperative evaluation according to the position of organs with regard to the pubo-coccygeal line. We noted cystocele, hysterocele or enterocele when the bladder, the uterine cervix, or the Douglas' cul-de-sac came under this line during efforts of push. We measured length modifications and lateral and anteroposterior vaginal axis.


RESULTS
After the surgery, we noted that all pelvic organs were found above the reference line. On the other hand, bladders are significantly situated less high after vaginal pelvic floor repair. There is no postoperative difference as regards of the vaginal wall location. The lengths and vaginal axis are comparable in pre- and postoperative evaluation.


CONCLUSIONS
In our study, the anatomical results of pelvic floor repair performed by vaginal or abdominal route are short-term comparable and the vaginal approach is not responsible for decrease of length or vaginal reorientation. Standardized and longer term evaluated, the MRI can represent an objective and reproducible help to the staging of pelvic floor dysfunction.
Boukerrou
M
M
Pôle de chirurgie gynécologique, hôpital Jeanne-de-Flandre, CHRU de Lille, 2, avenue Oscar-Lambret, 59037 Lille, France. m-boukerrou@chru-lille.fr
Mesdagh
P
P
Yahi
H
H
Crépin
G
G
Robert
Y
Y
Cosson
M
M
D005260:Female; D013509:Gynecologic Surgical Procedures; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D017773:Pelvic Floor / Q000033:anatomy & histology / Q000293:injuries* / Q000601:surgery*; D011182:Postoperative Care; D011184:Postoperative Period; D016896:Treatment Outcome