Functional cine magnetic resonance imaging in women after abdominal sacrocolpopexy

Objective: To evaluate whether functional cine magnetic resonance imaging (MRI) is a reliable method for verifying postoperative anatomy and function in women after abdominal sacrocolpopexy. Methods: We did postoperative functional cine MRI in 25 women who had sacrocolpopexies. Visibility of grafts and vaginal and sacral fixation points were assessed and correlated with intraoperative results. Ranges of vaginal movement were calculated and compared with results of postoperative gynecologic examinations. Results: Functional cine MRI achieved full view of vaginas in all cases. The mean vaginal axis was 142 degrees. Grafts were entirely visible in 13 women, partly visible in nine, and not visible in three. Functional cine MRI defined exactly the sacral fixation points in 22 women. Compared with intraoperative results, functional cine MRI showed a higher level of fixation in nine of 11 women. Functional cine MRI defined exact vaginal fixations point in 15 of 25 women. According to the pubococcygeal reference line, the postoperative range of movement of the vaginal apex was 1.8 cm. Recurrent vaginal vault prolapses in three women were detected equally by functional cine MRIs and gynecologic examinations. In those cases, no parts of patches were seen on the images. Conclusion: Functional cine MRI provided reliable abdominal sacrocolpopexy follow-up data. It might help with individual surgical planning and augment understanding of benefits and flaws of various surgical approaches to repair of vaginal vault prolapse. (Obstet Gynecol 2001;47:81-5. (C) 2001 by The American College of Obstetricians and Gynecologists.)