[home] [Personal Program] [Help]

---

Session: Poster Session 1 (Even numbers)
Session starts: Thursday 26 January, 16:00
Presentation starts: 16:00

---

Frieda van den Noort (Postdoc, Multimodality medical imaging group, University of Twente)
Mirjam de Vries (Student, Multimodality medical imaging group, University of Twente)
Luyun Chen (Assistant Research Scientist in Biomedical Engineering, Biomechanics Research Laboratory, University of Michigan)
John de Lancey (Professor of gynecology, University of Michigan)
Anique Grob (Assistent professor, Multimodality medical imaging group, University of Twente)

Abstract:
Introduction: Pelvic organ prolapse (POP) is the exposure of one or more pelvic organs outside the vaginal opening. POP is likely due to weakened pelvic floor muscles (PFM) and ligament support caused by vaginal delivery damage, aging, genetics or hormonal changes. We investigate the hypothesis that the PFM support from POP patients differs from controls. Furthermore, we investigate if the PFM support changes during the day. Some patients report symptom increase during the day, which we hypothesize might be due to changing PFM support. Methods: Upright 0.25T magnetic resonance imaging (MRI) data of 43 healthy volunteers and 15 POP patients was obtained in the morning, the early and late afternoon. PFM support was investigated by selecting 12 corresponding sagittal points on each MRI [1]. These points that reflect pelvic floor “sagging” were aligned and normalized and principal component (PC) analysis was applied to investigate shape differences, which allows us to analyse the PFM support by shape differences. The values of the first two PCs were used for statistical comparison between groups, using two-way ANOVA. Results: The first two PCs captured 61% and 33% of the shape variation. Both PCs showed significant difference between POP patients and controls (PC1 p<0.001 and PC2 p=0.049). No statistically significant differences were found at different daytime points for both PCs. Visual examination of PC1 revealed that it mostly captures the cranial/caudal shape variation, the average POP population shape is more caudal compared to controls, suggesting lower support. PC2 captures mostly the length shape variation, visual difference was minimal between groups. Conclusion: Visual and statistical comparison of the difference in PFM support between POP patients and controls strengthens the hypothesis that weakened PFM support is one of the underlying POP causes. No significant difference in PC shape is found during the day in both POP patients and controls. Comment: The PFM support may not explain the reported symptom increase later in the day in women with POP. However, the POP group in this study is small and not all patients report symptom increase. Further research including only POP patients reporting symptom increase is beneficial [1] P. Schmidt, L. Chen, J. O. DeLancey, and C. W. Swenson, “Preoperative level II/III MRI measures predicting long-term prolapse recurrence after native tissue repair,” Int Urogynecol J, vol. 33, no. 1, pp. 133–141, Jan. 2022, doi: 10.1007/s00192-021-04854-3.