van der Steen Annemarie, Simonis Frank F J, Grob Anique T M
Multi Modality Medical Imaging (M3I), TechMed Centre, University of Twente, Drienerlolaan 5, 7522, NB, Enschede, The Netherlands.
Department of Gynecology, Ziekenhuisgroep Twente, Hengelo/Almelo, The Netherlands.
Int Urogynecol J. 2025 Jul;36(7):1541-1544. doi: 10.1007/s00192-025-06182-2. Epub 2025 Jun 4.
When pelvic organ prolapse (POP) patients change from pessary to surgical treatment, new POP quantification is often necessary. However, the time to maximal POP recurrence after pessary removal is unclear. This video-article illustrates the variation over time of POP extent after pessary removal.
Upright MRI scans of 12 POP patients were used to measure the distances from the lowest points of bladder and cervix to the Pelvic Inclination Correction System (PICS)) line, with the pessary in situ, immediately, 4 and 8 h after pessary removal. Statistical differences between time points were determined.
The bladder descended immediately after pessary removal from a median of 0.1 cm above to 1.8 cm below the PICS line. In 58% of patients, the bladder then remained stable; in 33%, the bladder further descended up to 5.4 cm after 4 to 8 h. The cervix descended immediately after pessary removal from a median of 3.1 cm to 1.9 cm above the PICS line. In 17% of patients, a late cervix descent after 4-8 h was seen.
POP quantification should be delayed at least 8 h after pessary removal to prevent underestimation of POP extent.
当盆腔器官脱垂（POP）患者从使用子宫托改为手术治疗时，通常需要重新进行POP量化评估。然而，取出子宫托后POP最大复发时间尚不清楚。本文通过视频展示了取出子宫托后POP程度随时间的变化。
对12例POP患者进行直立位MRI扫描，测量子宫托在位时、取出后即刻、4小时及8小时膀胱最低点和宫颈最低点至骨盆倾斜矫正系统（PICS）线的距离，并确定各时间点之间的统计学差异。
取出子宫托后，膀胱立即下降，从PICS线以上中位数0.1 cm降至PICS线以下1.8 cm。58%的患者膀胱随后保持稳定；33%的患者在4至8小时后膀胱进一步下降，最多达5.4 cm。取出子宫托后，宫颈立即下降，从PICS线以上中位数3.1 cm降至PICS线以上1.9 cm。17%的患者在4 - 8小时后出现宫颈延迟下降。
取出子宫托后，POP量化评估应至少延迟8小时，以防止低估POP程度。
