{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T05:44:31Z","timestamp":1768283071769,"version":"3.49.0"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T00:00:00Z","timestamp":1630886400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01 HD094954"],"award-info":[{"award-number":["R01 HD094954"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000071","name":"National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["K12 HD065257"],"award-info":[{"award-number":["K12 HD065257"]}],"id":[{"id":"10.13039\/100000071","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to develop and test the feasibility of a magnetic resonance imaging\u00a0(MRI)\u2010based measurement strategy to evaluate the effectiveness of surgical procedures in restoring normal anatomy in all three systems of pelvic floor support and quantify the structural changes induced by prolapse surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients underwent clinical examination and stress MRI preoperatively and again 3 months postoperatively. Preoperative and postoperative measures of three MRI\u2010based structural support systems were made: (1) vaginal wall, (2) apical and paravaginal support, and (3) hiatal closure system. Preoperative to postoperative structural changes were calculated and compared to normal values, and bivariate associations were determined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The three structural support systems were successfully quantified for both preoperative and postoperative MRIs regardless of operative approaches in all 15 women in the pilot group. Apical support was restored to normal in 11 of 12 patients who underwent an apical suspension procedure and 9 of 14 patients with a posterior repair had normalization of genital hiatus size. Mid\u2010vaginal paravaginal location was elevated an average of 2.5\u2009\u00b1\u20092.0\u2009cm despite no paravaginal repairs being performed. Paravaginal location improvements were also significantly correlated with apical elevation (<jats:italic>r<\/jats:italic> values 0.99\u20130.87, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A strategy that quantifies structural\u2010specific preoperative impairments and improvements after prolapse surgery was successfully developed. Early findings reveal that prolapse surgery is more successful in restoring normal anatomy at Level I than Level III. Improvement in paravaginal location is significantly correlated with apical elevation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.24781","type":"journal-article","created":{"date-parts":[[2021,9,6]],"date-time":"2021-09-06T18:22:23Z","timestamp":1630952543000},"page":"1989-1998","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["A new 3D stress MRI measurement strategy to quantify surgical correction of prolapse in three support systems"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6861-180X","authenticated-orcid":false,"given":"Luyun","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor Michigan USA"},{"name":"Pelvic Floor Research Group University of Michigan Ann Arbor Michigan 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Arbor Michigan USA"},{"name":"Pelvic Floor Research Group University of Michigan Ann Arbor Michigan USA"},{"name":"Department of Mechanical Engineering University of Michigan Ann Arbor Michigan USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1012-7713","authenticated-orcid":false,"given":"John O.","family":"DeLancey","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology University of Michigan Ann Arbor Michigan USA"},{"name":"Pelvic Floor Research Group University of Michigan Ann Arbor Michigan 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