Suzan Menasce Goldman MD, PhD, Abstract Co-Author: Nothing to Disclose

Thiago Giansante Abud MD, Presenter: Nothing to Disclose

Gustavo Borghese, Abstract Co-Author: Nothing to Disclose

Rogerio Simonetti, Abstract Co-Author: Nothing to Disclose

Homero Bruschini, Abstract Co-Author: Nothing to Disclose

Jacob Szejnfeld MD,PhD, Abstract Co-Author: Nothing to Disclose

Denis Szejnfeld MD, Abstract Co-Author: Nothing to Disclose

Nitamar Abdala MD, PhD, Abstract Co-Author: Nothing to Disclose

Valdemar Ortiz PhD, Abstract Co-Author: Nothing to Disclose

Miguel Srougi PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

to determine the potential advantage of MRI videourodynamics in the evaluation of SUI and pelvic floor dysfunction, with the association of dynamic fastscan MRI with urodynamic evaluation

Seven patients were evaluated for SUI. All patients had a comprehensive history, physical examination, standard multi-channel urodynamic study and MRI videourodynamic, as described before. Cistometry were performed in the supine position in both studies. Valsalva maneuvers were performed at three different occasions with the bladder volumes at 150, 250 and 350mls and the VLPP and the MRI Valsalva urethral filling pressure (VUFP) were determined. Pelvic floor laxity was evaluated by the H line and the M line. Both of these lines become elongated during the Valsalva maneuver in the patient with pelvic floor laxity. MR was performed at a 1,5 T Sonata MC, Germany. Sequences: sagital TURBOFISP at the medium line, TA 1 sec/ measures: 250 (during urodynamic test). Vaginal Gel 20 ml was introduced by a seringe. Patients were instructed to do Valsalva and relax during acquisition. A combining video was created showing simultaneously the urodynamic test and dynamic cystoMR

In three patients urinary leakage was evident in both studies, but a lower VLPP was observed during MRI urodynamics. In two patients urinary leakage was only demonstrated in MRI urodynamics. In one patient it was not possible to demonstrate incontinence. Except for one patient, there was a positive correlation between a lower MRI Valsalva urethral filling pressure (VUFP) and the degree of levator ani complex lesion

MRI urodynamics seems to offer advantages to the evaluation of female SUI by providing a more sensitive urinary leakage detection and anatomical determination of levator ani complex lesion in a single study

to determine the potential advantage of MRI videourodynamics in the evaluation of SUI and pelvic floor dysfunction, with the association of dynamic fastscan MRI with urodynamic evaluation

Seven patients were evaluated for SUI. All patients had a comprehensive history, physical examination, standard multi-channel urodynamic study and MRI videourodynamic, as described before. Cistometry were performed in the supine position in both studies. Valsalva maneuvers were performed at three different occasions with the bladder volumes at 150, 250 and 350mls and the VLPP and the MRI Valsalva urethral filling pressure (VUFP) were determined. Pelvic floor laxity was evaluated by the H line and the M line. Both of these lines become elongated during the Valsalva maneuver in the patient with pelvic floor laxity. MR was performed at a 1,5 T Sonata MC, Germany. Sequences: sagital TURBOFISP at the medium line, TA 1 sec/ measures: 250 (during urodynamic test). Vaginal Gel 20 ml was introduced by a seringe. Patients were instructed to do Valsalva and relax during acquisition. A combining video was created showing simultaneously the urodynamic test and dynamic cystoMR

In three patients urinary leakage was evident in both studies, but a lower VLPP was observed during MRI urodynamics. In two patients urinary leakage was only demonstrated in MRI urodynamics. In one patient it was not possible to demonstrate incontinence. Except for one patient, there was a positive correlation between a lower MRI Valsalva urethral filling pressure (VUFP) and the degree of levator ani complex lesion

MRI urodynamics seems to offer advantages to the evaluation of female SUI by providing a more sensitive urinary leakage detection and anatomical determination of levator ani complex lesion in a single study

Goldman, S, Abud, T, Borghese, G, Simonetti, R, Bruschini, H, Szejnfeld, J, Szejnfeld, D, Abdala, N, Ortiz, V, Srougi, M, et al, , Magnetic Resonance Imaging (MRI) Urethral Filling under Valsalva Maneuver: A Potentially More Sensitive Way to Detect Female Stress Urinary Incontinence (SUI).  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4410248.html