A pelvic floor MRI scan is used to investigate pelvic floor dysfunction which is a spectrum of disorders that affect ligaments, and muscles that support the pelvic organs.
Bladder weakness and incontinence is a common problem estimated to affect millions of people in the UK to some degree. Symptoms include not only urinary symptoms, but constipation, lower back pain, pain during sex, muscle spasms and pain in the pelvic region and rectum.
One survey[i] of female patients reported that 40 per cent of those who responded said they suffered urinary incontinence and 17 per cent said they had consulted a doctor or nurse about their symptoms. It can hugely affect quality of life for some.
There are various types of incontinence, but stress incontinence, where urine leaks when the bladder is under pressure due to exercise, lifting, coughing, or sneezing, is the most common type in women and is treatable. Others include urge incontinence, where there is a sudden urge to pass urine and overflow incontinence, where it is difficult to fully empty the bladder and frequent leaking results. It’s also possible to have a mixture of stress and urge incontinence.
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A pelvic MRI scan is available for women and can give an in-depth picture of the pelvic floor muscles and ligaments which support the bladder, bowel, and uterus. Doctors use these scans to examine the structure of the pelvic floor and see which muscles are working, they can also assess muscle defects and any areas of damage.
Scans are performed with the patient standing, tilted at a comfortable 30° - 40° angle or occasionally seated. Scans will be taken whilst the patient is pushing or bearing down into the pelvic area in an open upright scanner.
The big advantage of a pelvic floor MRI scan done in an upright position is that it examines the pelvic floor muscles and surrounding pelvic organs when they are under the force of gravity giving a more realistic dynamic picture of how muscles and ligaments respond to pressure in an upright position.
The pelvic floor has three compartments: the anterior contains the bladder and urethra; the middle compartment contains the uterus, cervix and vagina, and the posterior contains the rectum. Many women with pelvic floor dysfunction have involvement of all three compartments and MRI provides simultaneous assessment of all of them. This is particularly useful to assess who may be suitable for surgery and may reduce the risk of surgical failure or persistence or recurrence of symptoms after surgery.[ii]
Dynamic upright open MRI is helpful in evaluating persistent complaints both before and after surgery for pelvic organ prolapse (where pelvic organs such as the bladder or bowel droop down towards or into the vagina). It can be used to detect more defects than a physical examination or other imaging investigations, potentially avoiding the need for x-rays and is therefore safer. A pelvic MRI scan should also be considered when surgery has failed in severe and complex pelvic organ prolapse. It is important in assessing stress incontinence before surgery, accurately detecting anatomical changes associated with that condition.
Because of the open nature of an upright scanner the experience is also far less intimidating for people who suffer from claustrophobia.
A pelvic floor MRI scan is used to diagnose pelvic organs prolapse. This is where the bladder, bowel, or womb droop down and protrudes towards or into the vagina. If the bladder does this it is known as a cystocele or fallen bladder, a common condition in women where the bladder bulges onto the front wall of the vagina.
Symptoms can include problems passing urine, including a feeling of not being able to empty the bladder or leaking small amounts of urine on coughing, lifting, or sneezing. Causes include difficult childbirth (long labour), having multiple or heavy babies or menopause, as well as being overweight. People with certain inherited connective tissues disorders such as Ehlers-Danlos syndrome or Marfan syndrome are also more prone to prolapses. Treatment options include lifestyle changes to minimise symptoms such as losing weight, preventing constipation and straining, and avoiding heavy lifting and learning pelvic floor exercises. In more severe cases hormone creams, vaginal pessaries or surgical repair may be needed.
Open MRI scanners are a stress-free alternative to using a conventional enclosed tunnel MRI scanner, providing comfort and reassurance for people who suffer from anxiety or claustrophobia. Sitting upright is more comfortable for patients and the open front means patients can speak to a friend or relative or watch television throughout as distraction.
Open MRI scans can also accommodate larger/ heavier patients who might have difficulty fitting comfortably into a conventional tunnel scanner, as they can take weights of up to 35 stone (226kg). However, suitability will depend on the patient’s build and the area of anatomy that needs to be scanned.
The Upright MRI is truly open. There are no tunnels, no narrow tubes. The system is particularly quiet, the examination is comfortable and does not trigger feelings of being in a confined space. This means that the Upright MRI is particularly tolerated by patients who suffer from “claustrophobia”.
Because the system offers you an unrestricted view, you can watch TV or see DVD movies on a large screen during the scan. Wearing headphones – as with other MRI systems – is usually not necessary.
According to the current state of knowledge, there is no danger to the patient’s health as magnetic resonance imaging only uses magnetic fields and radio waves.
Metallic foreign bodies within the patient, such as fixed dental prosthesis, artificial joints or metal plates after treatment for a fracture do not usually pose any danger. However, it is important to clarify that the implants you use are MRI-compatible before the examination.
MRI (Magnetic Resonance Imaging) utilises a large magnet, radio waves and a computer to form images of your body. It is non-invasive, painless and does not use any ionising radiation.
Our truly open MRI can scan you in different positions. Through the utilisation of a specially designed MRI system we can offer weight-bearing scans – sitting or standing. The design of the system allows the patient to be positioned in different postures (e.g. flexion or extension) so that the patient may be examined in the position where they experience pain. The reason to do this is that some pathologies are underestimated or even not seen in a conventional supine MRI scan. The technique has value in many applications: e.g. spine, knees, hips, ankles. This has been proven in scientific studies and documented in peer reviewed publications.
In addition, it offers the possibility of performing an MRI scan on patients who could not otherwise tolerate the examination. This may include the claustrophobic patient, who benefits from the truly open nature of the equipment, and the severely kyphotic patient or emphysema sufferer who simply cannot lie down. It can also facilitate scanning of large patients who struggle to fit conventional ‘bore’ MRI scanners.
Of course, we have a comfortable waiting area but if you want them to stay in the scan room with you, they will also need to fill out a safety questionnaire. There is enough space for a companion. The person can even hold your hand and communicate with you during the examination. This is particularly beneficial when examining teenager.
This depends above all on which part of the body needs to be examined. In the Upright MRI, special examinations can be carried out in various body positions. The entire scan generally takes between 30 and 45 minutes. However, since you have the opportunity to watch TV or DVD, this time will go by much quicker.
Eat and drink normally and, unless your doctor tells you otherwise, please continue taking medications as normal. If you have any special needs (e.g. wheelchair access) please inform us when making the appointment.
Your appointment confirmation; referral letter/form; Medical Insurance details if applicable. We accept all major debit/credit cards.
We will provide a gown/clothing for you to wear when you are scanned. If you prefer to wear your own, please ensure that you wear or bring clothing without any metal fasteners, zips or under-wiring as these cannot be worn in the scan room. The changing room can be locked for safe storage of your possessions.
You will be able to walk into the scanner. It has no tunnel or bore. You will be able to hear us and talk with us during your scan if necessary-and we will be able to see you at all times. Due to its open nature, you will even be able to watch TV or a DVD whilst having the scan. Depending on which part of you is being scanned, you may be asked to sit or stand, and assume different postures (for example bending forward.) The radiographer may place a receiver “coil” around the relevant area of your body. You will need to remain very still while the acquisition is done in order to prevent blurring of the images. You will hear some tapping from the scanner but in general it is much quieter than many other MRI scanners.
You will not feel anything while having the scan. There is no pain or unusual feeling of any type and you will experience no after effects.
YES. There are some things that can prevent you from having an MRI scan. You will be asked to complete a safety questionnaire on arrival at the Centre which will cover the contra-indications-but if you are making an appointment and any of the factors below affect you, please discuss this with us in advance as it may save you a wasted trip.
Contra-indications can include:
It is also important to tell us if you have any tattoos or piercings.
Watches, jewellery, coins, keys, cigarette lighters, penknives, credit cards. piercings, hairgrips, wigs, nicotine patches, and hearing aids must be removed.
Your scan will be reported by a Consultant Radiologist. It will normally be available in a couple of days unless needed urgently. The images and report will be sent to your referring practitioner. If you have a follow up appointment, please make us aware of the details so we can ensure the report and images are available in time.