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Ask the Doctor – Andrew Keyoung, M.D.


Q: What is pelvic organ prolapse and how can imaging detect if you have it?

A: Pelvic organ prolapse is a condition in which a woman’s pelvic floor – which holds up the pelvic organs including the bladder, uterus, vagina, small intestine and rectum – weakens and sags. Due to the weakening, various organs sink or prolapse into the vagina. This is a common disorder affecting 30% of women ages 20-59 years and up to 50% of women over the age of 50. 

Common symptoms include seeing or feeling a pelvic bulge during exercise, at the end of the day or after standing for long periods of time. While pelvic organ prolapse is usually not an emergency, it can be associated with pelvic pain, chronic constipation and sometimes even incontinence.

A woman experiencing these symptoms should speak to her physician. Her physician may perform a thorough pelvic examination and recommend magnetic resonance imaging (MRI) to visualize the pelvic floor and assess the degree of prolapse.

At Hoag, utilizing recent imaging advancements, we can visualize the pelvic floor and assess for pelvic organ prolapse.

Real time dynamic images of the pelvic region including muscles and ligaments are obtained while a woman performs certain maneuvers with the pelvic muscles and rectum. Once complete, our expert fellowship-trained Hoag radiologists interpret the exam and communicate a detailed report to Hoag subspecialists who assist with treatment. 

This MRI exam allows radiologists to ascertain far more information about the prolapse than alternative imaging exams, such as X-ray fluoroscopy. As an added benefit, the MRI exam has no ionizing radiation and provides clear visualization of the anatomy of the pelvic region including muscles and ligaments that cannot be visualized by X-ray. 

Hoag’s Pelvic Health Program consists of a multidisciplinary team of pelvic health experts including radiologists, urogynecologists, gynecologists, physical therapists and other subspecialists who work together to provide a coordinated approach in the treatment of pelvic floor disorders. Various non-surgical and surgical treatment options are available.

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