title: Effect of a speculum blade on dynamic MRI evaluation of pelvic organ prolapse.
abstract: We aimed to evaluate whether the use of a speculum blade modifies the evaluation of pelvic organ prolapse (POP) as assessed by dynamic magnetic resonance imaging (MRI). Twenty-seven women with POP Quantification (POPQ) stage II or greater, scheduled for POP surgery, were evaluated using MRI. The procedure was repeated using the posterior blade of a standard plastic Grave's speculum to successively retract the anterior and posterior vaginal walls. Standard POPQ was 15% stage II (n =4), 59% stage III (n =16) and 26% stage IV (n =7). The use of a blade evidenced hidden pelvic prolapsed compartments in 59% (n =16) of cases. For 48% of patients (n =13), the variation of the leading edge of at least one additional prolapsed compartment was diagnosed as more than 20 mm. In this series, the use of a speculum blade during dynamic MRI modified the POP evaluation in a large proportion of patients with POP stage > or =II.
authors.affiliation: Hôpital St Antoine, Assistance Publique Hôpitaux de Paris, Université Pierre et Marie Curie, Paris VI, Service de Gynécologie Obstétrique, 184 rue du Faubourg St Antoine, Paris, France.
authors.forename: Sarah
authors.initials: S
authors.lastname: Delaney
authors.forename: Pedro
authors.initials: P
authors.lastname: Fernandez
authors.forename: Amelie
authors.initials: A
authors.lastname: N'Guyen
authors.forename: Laurence
authors.initials: L
authors.lastname: Salomon
authors.forename: Bruno
authors.initials: B
authors.lastname: Carbonne
authors.forename: Jean Pierre
authors.initials: JP
authors.lastname: Laissy
authors.forename: Yan
authors.initials: Y
authors.lastname: Ansquer