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Master Thesis

Apport de l’IRM dynamique dans la nature de la prise en charge chirurgicale des prolapsus génitaux avec signes cliniques d’atteinte du compartiment postérieur

Abstract : Introduction: the purpose of this study was to determine the effect of dynamic pelvic floor MRI (dMRI) findings on surgical management of patients with pelvic organ prolapse (POP) presenting with symptoms correlated with posterior wall prolapse. Methods: we conducted a retrospective cohort study from 2017, January to 2018, December, in a french surgical facility, specialized in gynecologic functional surgery. All patients were referred for surgical management of POP. After clinical evaluation, the recommended surgical procedure was written in the medical file. In case of a clinical suspicion of a posterior wall prolapse, dMRI was prescribed. Surgical strategy was reevaluated in light of imaging findings. Results: out of 50 patients, dMRI was considered adequate in 47 of them (94%). Overall, the surgical procedure was modified 14 times (28%). Regarding rectoceles, radiological assessment was different from the physical exam’s in 29 cases: in 1 case it had been missed; 20 rectoceles were suspected clinically but not confirmed by MRI, in 8 cases the size of the rectoceles was reevaluated. Following dMRI, surgery was modified in 8 cases (27.6%). Regarding hernia of the Douglas pouch, radiological assessment was different in 16 cases: 8 had been missed; 8 were suspected clinically but not confirmed by MRI. These results led to 5 procedure changes (31.2%). Conclusion: dMRI findings help define clinical evaluation of posterior POP, and sometimes lead to a change in procedure choice.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03129889
Contributor : Université Paris Descartes - Scd Connect in order to contact the contributor
Submitted on : Wednesday, February 3, 2021 - 10:42:46 AM
Last modification on : Wednesday, June 9, 2021 - 3:22:29 AM

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  • HAL Id : dumas-03129889, version 1

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Marine Commissaire. Apport de l’IRM dynamique dans la nature de la prise en charge chirurgicale des prolapsus génitaux avec signes cliniques d’atteinte du compartiment postérieur. Médecine humaine et pathologie. 2019. ⟨dumas-03129889⟩

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