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A subset of participants who enrolled in Defining Mechanisms of Anterior Vaginal Wall Descent (DEMAND) underwent MRI at rest, maximal strain, and post-strain rest (recovery) 30\u201342\u00a0months after surgery or prior to 30\u00a0months if undergoing reoperation for recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 88 participants analyzed (aged 65\u2009\u00b1\u20097.7\u00a0years), 22 (25.0%) had surgical failure by clinical criteria, 8\/45 (17.8%) VM-hysteropexy; 14\/43 (32.6%) NTR-hysterectomy,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.14. Larger genital hiatus (H-line, 86.5\u00a0mm vs 72.3\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003), low posterior position during strain (M-line, 55.6\u00a0mm vs 40.3\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005), and apical\u00a0compartments (vaginal apex position below pubococcygeal line (PCL), 42.1\u00a0mm vs 13.1\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) were associated with failure vs success after VM-hysteropexy. In the NTR-hysterectomy group, failures demonstrated greater vaginal width (46.3\u00a0mm vs 41.3\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), vaginal circumference (108.5\u00a0mm vs 96.1\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), and bladder descent vs successes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Pelvic MRI parameters associated with surgical failure vs success varied between VM-hysteropexy and vaginal hysterectomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00192-026-06699-0","type":"journal-article","created":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T09:58:58Z","timestamp":1780135138000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MRI 2-D Parameters Associated with Native Tissue or Transvaginal Mesh Surgical Apical Prolapse Repair Failure"],"prefix":"10.1007","author":[{"given":"Mark E.","family":"Lockhart","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela A.","family":"Moalli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7741-5771","authenticated-orcid":false,"given":"Holly E.","family":"Richter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isuzu","family":"Meyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison C.","family":"Weidner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuko M.","family":"Komesu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Carper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie G.","family":"Gantz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Eunice Kennedy Shriver NICHD Pelvic Floor Disorders Network","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberly","family":"Ferrante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherella","family":"Johnson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily S.","family":"Lukacz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles W.","family":"Nager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gouri B.","family":"Diwadkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisha Y.","family":"Dyer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda M.","family":"Mackinnon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasmine","family":"Tan-Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gisselle","family":"Zazueta-Damian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Amundsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasmeen","family":"Bruton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Notorious","family":"Coleman-Taylor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amie","family":"Kawasaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Longoria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shantae","family":"McLean","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazema","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Weidner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy","family":"Carter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. 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Uncompensated potential conflicts include Chair ABR Ultrasound Certifying Committee, Member of Editorial Boards for Radiology, JUM, and Ultrasound Quarterly.P Moalli research funding from NIH\/NICHD R01 and R21 funding mechanisms and the Richard King Mellon Foundation.HE Richter: Research funding: PCORI (Brown\/Dartmouth Universities), NIDDK, NICHD, NIAMS, COSM; Royalties: Up-to-Date; Travel and Reimbursement Related to Editor Duties: IUJ; Board of Directors: Worldwide Fistula Fund; DSMB: Bluewind, Cook Myosite, Juniper Medica; Consultant: Neomedic, Coloplast, Palette Life Science, COSM, Laborie, ICA, Axena, Moremm\u00e9, Eli Lilly; CME Speaker: Symposia Medicus.I Meyer has no additional disclosures.A Weidner reported receiving personal fees from Wolters Kluwer as associate editor for Obstetrical and Gynecological Survey, consultant fees from Urocure, and research funding through Ethicon and Hologic.Y Komesu has no additional disclosures.M Gantz has no additional disclosures.B Carper has no additional disclosures.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interests"}}]}}