Dynamic magnetic resonance imaging of the pelvic floor in children and adolescents with vesical and anorectal malformations.

Full Abstract

BACKGROUND:
Magnetic resonance imaging (MRI) of the pelvic floor allows better assessment of pelvic pathology and has a potential as an adjunct for therapy planning. In complex congenital malformations of the pelvic floor and continence organs, it plays a major role in assessing urinary and fecal incontinence or constipation, especially when performed as a dynamic investigation such as MRI defecography.

PATIENTS AND METHODS:
Twenty-three patients (3-21 years old) with urinary and/or fecal incontinence or constipation attributable to congenital malformations of the pelvic region presented at our institution. The diagnoses were anorectal malformations (18), bladder exstrophy (2), and cloacal exstrophy (3). All patients underwent static and dynamic MRI of the pelvic floor with rest, squeeze, and evacuation in supine position.

RESULTS:
Morphology and function of the pelvic floor and pelvic organs could be demonstrated in each case. The reason for urinary incontinence, fecal incontinence, or constipation could be defined, and an individual therapeutic management concept was made based upon the data obtained by the investigation.

CONCLUSIONS:
The advantages of this method, in comparison to others, are direct visualization of the pelvic floor muscles and continence organs and their anatomical relationship during different functional actions. Pelvic floor dysfunction is often the reason for fecal and urinary incontinence and can be detected by MRI. Especially in children, minimizing radiation exposure is of major concern. Disadvantages are the costs and long investigation time.

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Author information

Author/s: Boemers, Thomas M (TM); Ludwikowski, Barbara (B); Forstner, Rosemarie (R); Schimke, Christa (C); Ardelean, Mircia A (MA);

Affiliation: Department of Pediatric Surgery, Children's Hospital of Cologne, 50735 Köln, Germany. kinderchirurgie(-atsign-)kliniken-koeln.de

Journal and publication information

Publication Type: Journal Article

Journal: Journal of pediatric surgery (J Pediatr Surg), published in United States. (Language: eng)

Reference: 2006-Jul; vol 41 (issue 7) : pp 1267-71

Dates: Created 2006/07/04; Completed 2006/09/21; Revised 2006/11/15;

PMID: 16818061, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Adolescent
Adult
Anal Canal - abnormalities; physiopathology
Child
Child, Preschool
Constipation - physiopathology
Fecal Incontinence - physiopathology
Female

Female
Humans
Magnetic Resonance Imaging - methods
Male
Pelvic Floor
Rectum - abnormalities; physiopathology
Urinary Bladder - abnormalities; physiopathology
Urinary Incontinence - physiopathology

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