Luisa Carone MD, Presenter: Nothing to Disclose

Joan Almolla, Abstract Co-Author: Nothing to Disclose

Ilaria Fulle MD, Abstract Co-Author: Nothing to Disclose

Giulia Van Der Byl MD, Abstract Co-Author: Nothing to Disclose

Sarah Alessi MD, Abstract Co-Author: Nothing to Disclose

Fabrizio Calliada MD, Abstract Co-Author: Nothing to Disclose

Functional disorders of the pelvic floor represent common and complex syndromes affecting about 20-25% of multiparous women with important social impact. Symptoms may vary ranging from constipation and fecal or urinary incontinence occurring in varying combinations. The cause often lies on impaired transmission of nerve impulse to the muscle structures of the pelvic floor, leading to condition of dyssynergia between different muscle groups. The aim of this study was to evaluate the possible relationship between the presence of sacral nerve root cysts (SNRC) and pelvic floor dysfunction (PFD)

A retrospective monocentric case-control trial was conducted between January 2007 and February 2010, enrolling 683 subjects. 406 patients (347 female and 59 male mean age: 54) with diagnosis of functional disorder of the pelvic floor and 277 patients (205 female and 72 male mean age: 48), asymptomatic for PFD but requiring pelvic MRI as control group. Both groups underwent pelvic MRI. PFD patients completed by dynamic acquisitions of pelvic floor after endorectal introduction of sonographic gel. Both protocols were conducted with 1.5-T magnet (Symphony, Siemens AG, Erlangen DE). Axial and sagittal T2TSE sequences were obtained for all 683 subjects

In asymptomatic subjects the detection of SNRC was incidental and was found in 14 cases (5%), similar with the incidence reported in the literature (4.6%). In patients with pelvic floor dysfunction SNRC were observed in 85 cases (21%) [p <0,001]. The most common clinical PFD/SNRC association were: descending perineal syndromes 80 (94%), spastic pelvic floor syndromes 58 (68%) and levator ani asymmetry 28 (33%)

Statistically significant association between the presence of SNRC and PFD may suggest their involvement in the pathogenesis of PFD, especially when, as usual, other organic cause is not found. Further studies to evaluate the role of SNRC in the PFD pathogenesis are needed

Sacral nerve root cysts should have a role in pathogenesis of pelvic floor dysfunction

Carone, L, Almolla, J, Fulle, I, Van Der Byl, G, Alessi, S, Calliada, F, Sacral Nerve Root Cysts: Incidental Benign MRI Finding or Pathologic Condition—May Sacral Nerve Root Cysts Have a Role in Pathogenesis of Pelvic Floor Dysfunction?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9010370.html