{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T13:40:27Z","timestamp":1789998027207,"version":"4.0.1"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,18]],"date-time":"2025-02-18T00:00:00Z","timestamp":1739836800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Obstet and Gynaecol"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Injury to and laxity of the pelvic floor muscles are highly important factors in the etiology of pelvic organ prolapse. When women with pelvic organ prolapse perform the Valsalva maneuver, progressive descent and widening of the levator ani muscle are observed on dynamic magnetic resonance images. However, physical examination of such women often reveals pelvic floor laxity, even in a relaxed state. Therefore, we aimed to verify the hypothesis that sagging of the pelvic floor can be detected on resting\u2010state magnetic resonance images in the supine position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively evaluated resting\u2010state magnetic resonance imaging findings in women with (<jats:italic>n<\/jats:italic>\u2009=\u2009193; all underwent surgical treatment) and without (controls; <jats:italic>n<\/jats:italic>\u2009=\u2009193) pelvic organ prolapse who had at least one prior vaginal delivery. We compared the lengths of the pubococcygeal line, H\u2010line, and M\u2010line between the groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median lengths (interquartile ranges) for the prolapse and control groups were 98.3 (91.9\u2013104.0) and 95.1 (90.3\u2013101.4) mm (<jats:italic>p<\/jats:italic>\u2009=\u20090.0011), respectively, for the pubococcygeal line; 61.5 (56.0\u201367.9) and 51.1 (47.2\u201355.6) mm (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), respectively, for the H\u2010line; and 24.6 (20.4\u201329.0) and 8.6 (3.9\u201313.0) mm (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.0001), respectively, for the M\u2010line. Similarly, in the multiple regression analysis adjusted for age, height, body mass index, a history of operative vaginal delivery, and a history of hysterectomy, the pubococcygeal line, H\u2010line, and M\u2010line were significantly longer in the prolapse group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In women with pelvic organ prolapse, the H\u2010line and M\u2010line are significantly longer on resting\u2010state magnetic resonance images, allowing for the detection of pelvic floor relaxation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jog.16248","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T05:14:36Z","timestamp":1739942076000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Reference line lengthening on resting\u2010state magnetic resonance imaging in patients with pelvic organ prolapse seeking surgical treatment"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4931-4399","authenticated-orcid":false,"given":"Yoshiyuki","family":"Okada","sequence":"first","affiliation":[{"name":"Department of Female Pelvic Health Center Showa University Northern Yokohama Hospital  Yokohama Kanagawa Japan"},{"name":"Department of Obstetrics and Gynecology Showa University Northern Yokohama Hospital  Yokohama Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2695-2301","authenticated-orcid":false,"given":"Chie","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Female Pelvic Health Center Showa University Northern Yokohama Hospital  Yokohama Kanagawa Japan"},{"name":"Department of Obstetrics and Gynecology Showa University Northern Yokohama Hospital  Yokohama Kanagawa 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