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Quantifying bladder prolapse in patients : how to improve patient care. The quantification of the anatomical result of bladder prolapse in symptomatic patients with stage 2 or more cystocele before and after the anterior colporrhaphy surgery visualized with an upright MRI

Rikkers, I.C. (2022) Quantifying bladder prolapse in patients : how to improve patient care. The quantification of the anatomical result of bladder prolapse in symptomatic patients with stage 2 or more cystocele before and after the anterior colporrhaphy surgery visualized with an upright MRI.

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Abstract:This study consisted of three parts, to quantify the bladder prolapse before and after the surgery, and to compare the MRI images to the physical examination as well as the AUGS tool, which is a visualization of the physical examination. The first part was about the quantification of the bladder prolapse before and after the anterior colporrhaphy surgery. Two new quantification methods were introduced besides the standard MRI analysis of the lowest point of the bladder. The first quantification method was the movement of the lowest point of the bladder, which is stated as the downwards descent of the bladder from the upright rest position to the upright straining position. This quantification method showed to be a possible predictive value for the recurrence of the bladder prolapse. The second quantification method aims to relate the MRI images to the ball-feeling symptom that the patients experience. This method uses the 3D segmented bladder to calculate the bladder volume under the reference line. Unfortunately, this quantitative measurement could not be compared to the symptoms the patients experience. However, with the new quantitative measurement of the movement of the bladder, it will be an additional method in analyzing bladder prolapses. With this information, the recurrence after the anterior colporrhaphy surgery could hopefully be reduced. The second part of this study aimed to find a comparison between the POP-Q, the physical examination, and the MRI images. The PICS reference line was used in the calculation of the lowest point of the bladder. It was hypothesized that the measurements of the supine MRI during straining would be most comparable to the lowest point of the bladder measured in the physical examination (POP-Q). In the results, the upright MRI in rest and the supine MRI during straining showed the same margin of error when compared to the POP-Q. Further research could help to find a good comparison between the physical examination and the MRI with the same outcomes. The third part of this study analyzed the AUGS tool (a visualization of patient-specific physical examination in a digital tool) and the MRI scan between patients to analyze the comparison. The results show a representable comparison, where only the shape of the bladder and the size of the uterus show large differences between the images. The representable AUGS tool to the MRI scan can help patients in visualizing the positions of their organs and their corresponding symptoms.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine MSc (60033)
Link to this item:https://purl.utwente.nl/essays/93769
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